| Doctor Name: | MS. COLLEEN MARIE DOHERTY |
| NPI Number: | 1568616464 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | PT33051 |
| Business Practice Address: | 888 N Main St Brockton, MA - 023011668 |
| Business Phone Number: | 5085876556 |
| Business Fax Number: | 5085881694 |
| Mailing Address: | 2900 Charlevoix Dr Se, Suite 200 GRAND RAPIDS |
| State: | MI |
| Postal Code: | 495467085 |
| Phone Number: | 6103344893 |
| Fax Number: | 8003251326 |
| NPI Enumeration Date: | 11/05/2008 |
| NPI Last Update Date: | 11/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT33051 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| 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 |