Taylan Jade Doherty
Physical Therapist in Durham, NC. Individual provider (NPI-1).
NPI number1659941706
StatusActive
Last updated in NPPESJun 30, 2021
Details
- NPI
- 1659941706
- Entity type
- Individual (NPI-1)
- Name
- Taylan Jade Doherty
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 30, 2021
- Certification date
- Jun 30, 2021
- Last updated
- Jun 30, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | P20162 | NC | Yes |
Practice location
2301 Erwin RdDurham, NC 27705-4699
Phone 919-681-2030
Mailing address
2301 Erwin RdDurham, NC 27705-4699
Phone 919-681-2030
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