Individual
SUSAN FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1501 MAIN ST, UNIT 2, TEWKSBURY, MA 01876-4725
(978) 851-9055
(978) 851-9033
Mailing address
1501 MAIN ST, UNIT 2, TEWKSBURY, MA 01876-4725
(978) 851-9055
(978) 851-9033
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2364
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1858852
HCVM
MA
01
—
351289
HPHC
MA
01
—
646572
ACN
MA
01
—
Y36639
BCBS OF MA
MA
Enumeration date
12/18/2006
Last updated
11/05/2007
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