Individual
CHRISTOPHER DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3207 N ACADEMY BLVD, SUITE 3500, COLORADO SPRINGS, CO 80917-5100
(719) 632-5700
Mailing address
3205 N ACADEMY BLVD, SUITE 130, COLORADO SPRINGS, CO 80917-5147
(719) 632-5700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9107495
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009889000
—
FL
05
—
38605813
—
CO
Enumeration date
09/19/2013
Last updated
04/03/2017
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