Individual
MISS MAUREEN HELEN DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1646 5TH AVE N, ESTHERVILLE, IA 51334-1760
(712) 362-3522
Mailing address
59 COTTAGE ST, FAIRMONT, MN 56031-2408
(507) 236-0973
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
00823
IA
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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