| NPI | 1578065728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK D FERGUSON Owner 201-716-9199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 111NR0400X Chiropractor, Rehabilitation | |
| 207Q00000X Family Medicine | |
| 208D00000X General Practice | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2021-09-10 |