Provider Demographics
NPI:1871967166
Name:FERGUSON FAMILY CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:FERGUSON FAMILY CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:518-383-5595
Mailing Address - Street 1:653 PLANK RD
Mailing Address - Street 2:1
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3027
Mailing Address - Country:US
Mailing Address - Phone:518-383-5595
Mailing Address - Fax:518-383-5594
Practice Address - Street 1:653 PLANK RD
Practice Address - Street 2:1
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3027
Practice Address - Country:US
Practice Address - Phone:518-383-5595
Practice Address - Fax:518-383-5594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011391111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty