NPI | 1205944295 |
---|---|
Former Name | GLORIA LYNN FERGUSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CO 4647) |
Additional Taxonomies | 171100000X Acupuncturist |
Enumeration Date | 2006-08-29 |
Last Update Date | 2007-10-30 |