Individual
COLLEEN DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1145 OLENTANGY RIVER RD STE 2100, COLUMBUS, OH 43212-3117
(614) 293-3873
(614) 293-3078
Mailing address
1145 OLENTANGY RIVER RD STE 2100, COLUMBUS, OH 43212-3117
(614) 293-3873
(614) 293-3078
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50006441RX
OH
363AM0700X
Medical Physician Assistant
MA054221
PA
Other
Enumeration date
05/19/2011
Last updated
08/17/2020
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