Provider Demographics
NPI:1407093156
Name:FERGUSON, ANTON (COLD LASER THERIPST)
Entity Type:Individual
Prefix:
First Name:ANTON
Middle Name:
Last Name:FERGUSON
Suffix:
Gender:M
Credentials:COLD LASER THERIPST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5933 S TAFT ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-2327
Mailing Address - Country:US
Mailing Address - Phone:720-233-0730
Mailing Address - Fax:303-948-2646
Practice Address - Street 1:4747 S BALSAM WAY UNIT 23-102
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-5406
Practice Address - Country:US
Practice Address - Phone:720-233-0730
Practice Address - Fax:303-948-2646
Is Sole Proprietor?:No
Enumeration Date:2009-01-17
Last Update Date:2009-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other