Provider Demographics
NPI:1841369196
Name:DOERINGER, JEFFREY RYAN (LAT, ATC)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:RYAN
Last Name:DOERINGER
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 CARRIAGE HILL DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-3213
Mailing Address - Country:US
Mailing Address - Phone:570-362-3572
Mailing Address - Fax:
Practice Address - Street 1:121 CARRIAGE HILL DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-3213
Practice Address - Country:US
Practice Address - Phone:570-362-3572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2008-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0027732081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine