Provider Demographics
NPI:1386832889
Name:FERGUSON, JOHN MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:FERGUSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 CROSSING BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-4100
Mailing Address - Country:US
Mailing Address - Phone:518-383-5595
Mailing Address - Fax:518-383-5594
Practice Address - Street 1:54 CROSSING BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-4100
Practice Address - Country:US
Practice Address - Phone:518-383-5595
Practice Address - Fax:518-383-5594
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0113911111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor