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Individual

JEFFREY J FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
3860 MONROE RD, DE PERE, WI 54115-8399
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15692
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100190911
WI
Enumeration date
07/30/2014
Last updated
12/26/2023
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