Individual
KORI ELIZABETH FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7005 E OAK RIDGE ST, BROKEN ARROW, OK 74014-2894
(580) 763-7693
Mailing address
7005 E OAK RIDGE ST, BROKEN ARROW, OK 74014-2894
(580) 763-7693
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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