Individual
JOEL RYAN DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1475 KISKER RD STE 150, SAINT CHARLES, MO 63304-8789
(636) 498-7474
(636) 498-7475
Mailing address
1475 KISKER RD STE 150, SAINT CHARLES, MO 63304-8789
(636) 498-7474
(636) 498-7475
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2012004489
MO
Other
Enumeration date
02/09/2012
Last updated
02/09/2012
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