Individual
MISS KELLY ELISE FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAC, LAC
Contact information
Practice address
3115 BURNING SPRINGS RD APT 2A, LAUREL, MD 20724
(609) 338-8865
Mailing address
3115 BURNING SPRINGS RD APT 2A, LAUREL, MD 20724-6062
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
U02418
MD
Other
Enumeration date
08/25/2017
Last updated
08/25/2017
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