NPI 1053854182

Jane Ferguson, PTA

Practitioner Contractor Gaylord, MI

Practice location

Address: 508 Random Ln, Gaylord, MI 49735-9304
Phone: (989) 732-3508
Mailing address: PO Box 521, Higgins Lake, MI 48627-0521

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence 5502000808 (MI)

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Registry record

NPI: 1053854182
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 Nov 2016
Record last updated: 21 Nov 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.