Individual
JACE COOPER FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2505 US HIGHWAY 431, BOAZ, AL 35957-5908
(256) 593-8310
Mailing address
802 COBRA ST, BOAZ, AL 35957-1108
(256) 572-8309
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2566
AL
Other
Enumeration date
02/03/2026
Last updated
02/03/2026
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