Individual
SKYLER JOHN DOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1147 U.S. HWY 80, POOLER, GA 31322
(912) 748-1506
(912) 748-1507
Mailing address
505 HARRIS TRAIL RD APT 2G, RICHMOND HILL, GA 31324-4243
(912) 484-2177
(912) 748-1507
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT008933
GA
Other
Enumeration date
11/14/2013
Last updated
11/14/2013
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