Individual
JENNIFER FERGUSON DIVITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT, CSCS
Contact information
Practice address
99 WOLF CREEK BLVD, SUITE 2, DOVER, DE 19901-4968
(302) 734-8000
(302) 734-0102
Mailing address
99 WOLF CREEK BLVD, SUITE 2, DOVER, DE 19901-4968
(302) 734-8000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
J10001606
DE
2251E1200X
Ergonomics Physical Therapist
J10001606
DE
2251G0304X
Geriatric Physical Therapist
J10001606
DE
2251S0007X
Sports Physical Therapist
J10001606
DE
2251X0800X
Orthopedic Physical Therapist
Primary
J10001606
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146729900
DEPART OF LABOR
DE
01
—
2623565000
AMERIHEALTH
DE
Enumeration date
04/11/2006
Last updated
09/26/2012
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