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General NPI Number Information
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NPI Number | 1083835573
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Entity Type | Individual
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Provider Name | ROBERT CLARENCE FERGUSON OTR
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1500 E. MEDICAL CENTER DR. OCCUPATIONAL THERAPY DEPARTMENT
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City | ANN ARBOR
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State | MI
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Zip | 48109
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Country | US
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Telephone | 734-936-7070
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Fax |
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Provider Business Mailing Address
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Address Line | 2722 DAYTON DR.
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City | ANN ARBOR
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State | MI
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Zip | 48108
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Country | US
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Telephone | 734-975-8611
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | 5201004716
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License Number State | MI
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