| Lisa Marie Dougherty, PT, DPT | |
|
660 Lake Joy Rd Ste D, Kathleen, GA 31047-2382 | |
| (478) 313-5385 | |
| Not Available |
| Full Name | Lisa Marie Dougherty |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 660 Lake Joy Rd Ste D, Kathleen, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164538773 | NPI | - | NPPES |
| 52676665 | Other | GA | BLUE CROSS BLUE SHIELD |
| 000950573A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT006185 (Georgia) | Primary |
| Provider Name | Independent Physical Therapy Of Georgia Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1780636068 PECOS PAC ID: 2961312244 Enrollment ID: O20040303000396 |
| Provider Name | Benchmark Physical Therapy, Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1083666903 PECOS PAC ID: 1557395209 Enrollment ID: O20050921001120 |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Marie Dougherty, PT, DPT 1200 Corporate Dr Ste 400, Hoover, AL 35242-5424 Ph: (866) 518-0283 | Lisa Marie Dougherty, PT, DPT 660 Lake Joy Rd Ste D, Kathleen, GA 31047-2382 Ph: (478) 313-5385 |
Ms. Regina Catherine Wuest, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2510 Ga Highway 127, Kathleen, GA 31047 Phone: 478-971-1153 Fax: 478-971-1171 | |
Marilyn Abraham, PT Physical Therapist Medicare: May Accept Medicare Assignments Practice Location: 2510 Ga Highway 127, Kathleen, GA 31047 Phone: 478-971-1153 Fax: 478-971-1171 | |
Micah Lea Hurrelbrink, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 660 Lake Joy Rd Ste D, Kathleen, GA 31047 Phone: 478-313-5385 | |
Mr. Francis Vitalis Arthur Jr., PHYSICAL THERAPIST Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2510 Ga Highway 127, Kathleen, GA 31047 Phone: 478-971-1153 Fax: 478-971-1171 | |
Anthony Robert Cochran, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 660 Lake Joy Rd Ste D, Kathleen, GA 31047 Phone: 478-313-5385 Fax: 478-313-5429 | |
Riya Patel, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 660 Lake Joy Rd Ste D, Kathleen, GA 31047 Phone: 478-313-5385 |