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Individual
MR. GREG CLARKE FERGUSON
Active
Individual
MR. GREG CLARKE FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH RN
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
094000338
OR
183500000X
Pharmacist
8139
OR
Other
Enumeration date
03/10/2012
Last updated
09/28/2012
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