Individual
DIANE S FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
7645 MARKET ST STE 110, YOUNGSTOWN, OH 44512-6098
(330) 965-9330
Mailing address
PO BOX 392573, PITTSBURGH, PA 15251-9500
(724) 343-4060
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT004580
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA002313E
PA PT LICENSE
PA
01
—
PT4580
PT LICENSE
OH
Enumeration date
08/18/2008
Last updated
10/02/2024
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