Doctor Name: | MARK S DAUGHERITY |
NPI Number: | 1043579667 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MPT |
License Number: | PT-0500 |
Business Practice Address: | 201 E 2nd St Suite 14 Casper, WY - 826012582 |
Business Phone Number: | 3073371624 |
Business Fax Number: | |
Mailing Address: | 201 E 2nd St, Suite 14 CASPER |
State: | WY |
Postal Code: | 826012582 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/16/2012 |
NPI Last Update Date: | 05/16/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT-0500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |