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Individual

JUSTIN DAUGHERTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTR

Contact information

Practice address
200 TRADE ST, TARBORO, NC 27886-5055
(252) 823-8100
Mailing address
200 TRADE ST, TARBORO, NC 27886-5055
(252) 823-8100

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8909
NC

Other

Enumeration date
03/27/2014
Last updated
03/27/2014
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