Individual
MR. JOHN JOSEPH DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T., A.T.C.
Contact information
Practice address
1950 45TH AVE, SUITE 200, MUNSTER, IN 46321-3917
(219) 922-8188
(219) 922-8502
Mailing address
1950 45TH AVE, SUITE 200, MUNSTER, IN 46321-3917
(219) 922-8188
(219) 922-8502
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
05001844A
IN
2255A2300X
Athletic Trainer
36000225A
IN
Other
Enumeration date
08/22/2007
Last updated
08/22/2007
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