Individual
MISS ANDREA FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
149 STALLION LN, LINO LAKES, MN 55014-7004
(651) 253-9397
Mailing address
149 STALLION LN, LINO LAKES, MN 55014-7004
(651) 253-9397
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1026
MN
Other
Enumeration date
08/19/2013
Last updated
08/19/2013
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