Individual
BECKY ANNE FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
604 SHANNON RD, PONCA CITY, OK 74601
(580) 761-1604
Mailing address
604 SHANNON RD, PONCA CITY, OK 74601
(580) 761-1604
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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