Individual
TEAGAN FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
90 HOPE DR BLDG 6000, MOUNTAIN HOME AFB, ID 83648-1062
(208) 828-4626
Mailing address
90 HOPE DR BLDG 6000, MOUNTAIN HOME AFB, ID 83648-1062
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/15/2017
Last updated
05/16/2022
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