Provider Demographics
NPI:1770225948
Name:FERGUSON, ANGELA KAY (PT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:KAY
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:KAY
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6900 GRAY RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-3209
Mailing Address - Country:US
Mailing Address - Phone:317-788-2500
Mailing Address - Fax:317-739-4115
Practice Address - Street 1:1450 E CROSSING BLVD
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-5316
Practice Address - Country:US
Practice Address - Phone:812-575-4057
Practice Address - Fax:317-739-4115
Is Sole Proprietor?:No
Enumeration Date:2022-04-08
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist