Individual
DR. BRENT DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
606 N BROADWAY ST, JOHNSON CITY, TN 37601-3535
(423) 232-1524
Mailing address
408 S ROAN ST, APT 202, JOHNSON CITY, TN 37601-5704
(423) 572-1017
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
36932
TN
Other
Enumeration date
07/19/2012
Last updated
07/19/2012
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