Individual
MARISA FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
200 PATEWOOD DR STE C150, GREENVILLE, SC 29615-6323
(864) 454-0904
(864) 454-0905
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12857
CT
Other
Enumeration date
09/15/2020
Last updated
07/31/2023
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