Individual
MR. ROGER DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
MADIGAN ARMY MEDICAL CTR, TACOMA, WA 98431-0001
(253) 968-1157
Mailing address
21016 137TH AVENUE CT E, GRAHAM, WA 98338-6627
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT00007101
WA
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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