Individual
BRADLEY L FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
1102 W SPRUCE ST, RAWLINS, WY 82301-5335
(307) 370-9175
(307) 370-9177
Mailing address
2002 W SUNSET DR, RIVERTON, WY 82501-2283
(073) 709-1753
(307) 370-9177
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1763
WY
225100000X
Physical Therapist
9632024
WI
2251X0800X
Orthopedic Physical Therapist
PT-1763
WY
Other
Enumeration date
09/13/2005
Last updated
07/03/2023
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