Individual
JENNY BROOKE FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
11148 PLUM DR, URBANDALE, IA 50322-6328
(515) 270-6338
(515) 270-6885
Mailing address
PO BOX 146, BAXTER, IA 50028-0146
(515) 270-6338
(515) 270-6885
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
074589
IA
Other
Enumeration date
06/25/2009
Last updated
11/16/2017
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