Provider Demographics
NPI:1295133965
Name:FERGUSON, LAURA GAIL (PT)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:GAIL
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 SW MULVANE ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1678
Mailing Address - Country:US
Mailing Address - Phone:785-295-5577
Mailing Address - Fax:785-295-5415
Practice Address - Street 1:634 SW MULVANE ST
Practice Address - Street 2:SUITE 404
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1678
Practice Address - Country:US
Practice Address - Phone:785-295-5577
Practice Address - Fax:785-295-5415
Is Sole Proprietor?:No
Enumeration Date:2014-12-12
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-01442225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist