Individual
JONATHAN FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
26301 LA-1088, MANDEVILLE, LA 70448
(985) 624-5046
Mailing address
1000 OCHSNER BLVD, COVINGTON, LA 70433-8107
(985) 875-2828
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.200450
LA
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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