MEDICARE: PETER D FERGUSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1801975073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PETER D FERGUSON

Provider Business Mailing Address
First Line	:	3507 CLEVELAND AVE NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44709-2748
Country	:	US
Telephone Number	:	330-493-7970
Fax Number	:	330-493-7410

Provider Business Practice Location Address
First Line	:	3507 CLEVELAND AVE NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44709-2748
Country	:	US
Telephone Number	:	330-493-7970
Fax Number	:	330-493-7410

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PETER D FERGUSON
Credential	:	DO
Telephone Number	:	330-493-7970

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	04/04/2011

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Directions to “PETER D FERGUSON ” Practice Location

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