Individual
JASON FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
947 S 6TH ST, PHILADELPHIA, PA 19147-4039
(215) 508-9215
Mailing address
947 S 6TH ST, PHILADELPHIA, PA 19147-4039
(215) 508-9215
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/24/2019
Last updated
06/24/2019
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