Provider Demographics
NPI:1699182956
Name:FERRELL, MARIEFLOR IRINGAN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:MARIEFLOR
Middle Name:IRINGAN
Last Name:FERRELL
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 SARAH DR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MO
Mailing Address - Zip Code:65010-1167
Mailing Address - Country:US
Mailing Address - Phone:573-429-3641
Mailing Address - Fax:
Practice Address - Street 1:205 SARAH DRIVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MO
Practice Address - Zip Code:65010
Practice Address - Country:US
Practice Address - Phone:573-429-3641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-18
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1048702251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics