Individual
SAMANTHA DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O. D.
Contact information
Practice address
2316 MEETINGHOUSE RD, UPPER CHICHESTER, PA 19061-3438
(610) 485-1500
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG003391
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OEG003391
PENNSYLVANIA OPTOMETRY LICENSE
PA
Enumeration date
06/25/2015
Last updated
05/19/2023
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