| NPI | 1972780187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY L FERGUSON Owner 608-249-6239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: WY PT-1763) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: WI 9632-024) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2018-06-06 |