Organization
INDEPENDENT PROVIDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MARTIN FERGUSON (INDEPENDENT)
(937) 692-8081
Entity
Organization
Contact information
Practice address
308 W 1ST ST, ARCANUM, OH 45304-1167
(937) 692-8081
Mailing address
308 W 1ST ST, ARCANUM, OH 45304-1167
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
05/13/2007
Last updated
08/22/2020
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