Individual
JARED FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1304 MORRIS CT, NORTH WALES, PA 19454-1050
(267) 546-6659
Mailing address
1280 ANDERS RD, LANSDALE, PA 19446-4845
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
DN0063
PA
Other
Enumeration date
11/22/2017
Last updated
11/22/2017
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