Provider Demographics
NPI:1437726379
Name:FERGUSON, SHAUNA (PT, SCD)
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:PT, SCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8214 MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-0962
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8214 MILWAUKEE AVE STE 200
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-0959
Practice Address - Country:US
Practice Address - Phone:806-475-5544
Practice Address - Fax:806-475-5545
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist