Provider Demographics
NPI:1124195201
Name:FERLAND, JAMES (PT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:FERLAND
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360-9 NORTH MAIN STREET
Mailing Address - Street 2:COMMUNITY PHYSICAL THERAPY
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-2116
Mailing Address - Country:US
Mailing Address - Phone:860-621-7389
Mailing Address - Fax:860-621-2586
Practice Address - Street 1:360-9 NORTH MAIN STREET
Practice Address - Street 2:COMMUNITY PHYSICAL THERAPY
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-2116
Practice Address - Country:US
Practice Address - Phone:860-621-7389
Practice Address - Fax:860-621-2586
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4087225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004239019Medicaid