Individual
THOMAS R FERGUSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2510 S RESERVE ST, MISSOULA, MT 59801-7546
(406) 721-5925
(406) 721-3859
Mailing address
2510 S RESERVE ST, MISSOULA, MT 59801-7546
(406) 721-5925
(406) 721-3859
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
387
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
482053
—
MT
Enumeration date
06/05/2006
Last updated
07/08/2007
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