Individual
MR. JASON A DOUGHERTY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2801 LANCASTER AVE, WILMINGTON, DE 19805-5232
(302) 778-0810
(302) 778-0812
Mailing address
334 PATRIOT DR, LOGAN TWP, NJ 08085-4254
(856) 241-1970
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
J2-0000625
DE
Other
Enumeration date
06/06/2006
Last updated
07/08/2007
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