Individual
MS. COLLEEN MARIE DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
888 N MAIN ST, BROCKTON, MA 02301-1668
(508) 587-6556
(508) 588-1694
Mailing address
2900 CHARLEVOIX DR SE, SUITE 200, GRAND RAPIDS, MI 49546-7085
(610) 334-4893
(800) 325-1326
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
10513
NC
225100000X
Physical Therapist
1178633
TX
225100000X
Physical Therapist
Primary
18333
MA
225100000X
Physical Therapist
2757
HI
225100000X
Physical Therapist
PT015950
PA
225100000X
Physical Therapist
PT33051
CA
Other
Enumeration date
11/05/2008
Last updated
11/05/2008
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