Individual
MADISON FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
464 SAINT LUKES DR, MONTGOMERY, AL 36117-7104
(205) 514-9483
Mailing address
6628 CRYSTAL LN, MOUNT OLIVE, AL 35117-3542
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH11610
AL
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
09/23/2019
Last updated
01/26/2024
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