Individual
DR. BRADLEY EDWARD DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D., M.S.
Contact information
Practice address
338 W 10TH AVE, COLUMBUS, OH 43210-1280
(614) 292-2020
Mailing address
338 W 10TH AVE, COLUMBUS, OH 43210-1280
(614) 292-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5715
OH
152WL0500X
Low Vision Rehabilitation Optometrist
5715
OH
Other
Enumeration date
07/25/2007
Last updated
07/25/2007
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