Individual
CHARLES FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMT
Contact information
Practice address
6813 GERMANTOWN AVE, PHILADELPHIA, PA 19119-2112
(215) 991-6151
Mailing address
1408 STOTESBURY AVE, WYNDMOOR, PA 19038-7444
(267) 971-9409
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
28469
PA
Other
Enumeration date
02/07/2007
Last updated
07/08/2007
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