Doctor Name: | CHUCK FERGUSON |
NPI Number: | 1134335862 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.M.T. |
License Number: | 1999201447 |
Business Practice Address: | 12 Fox Hunt Dr Bear, DE - 197012534 |
Business Phone Number: | 3028366150 |
Business Fax Number: | 3028366294 |
Mailing Address: | 12 Fox Hunt Dr, BEAR |
State: | DE |
Postal Code: | 197012534 |
Phone Number: | 3028366150 |
Fax Number: | 3028366294 |
NPI Enumeration Date: | 05/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 1999201447 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | DE |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |