| NPI | 1699275222 |
|---|---|
| Former Name | TRACI FERGUSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 65797) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT294359) |
| 2251X0800X Physical Therapist, Orthopedic | |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2025-10-14 |