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MATTHEW CHASE FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
1111 ROCKINGHAM DR, RICHARDSON, TX 75080-4309
(971) 231-8833
Mailing address
290 W LAKE PARK RD APT 925, LEWISVILLE, TX 75057-3888
(903) 738-3334

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2142878
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NA
N/A
Enumeration date
10/25/2018
Last updated
10/25/2018
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