Individual
MRS. BONITA A FERGUSON I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.PSC
Contact information
Practice address
711 E E AVE, JENKS, OK 74037-3351
(918) 928-2701
Mailing address
10026 A SOUTH MINGO ROAD, #173, TULSA, OK 74133
(918) 928-2701
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
L 5238622
—
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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