MEDICARE: MR. JAMES FERLAND PT

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	225100000X	Physical Therapist	4087	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124195201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES FERLAND PT

Provider Business Mailing Address
First Line	:	360-9 NORTH MAIN STREET
Second Line	:	COMMUNITY PHYSICAL THERAPY
City	:	SOUTHINGTON
State	:	CT
Zip	:	06489-2116
Country	:	US
Telephone Number	:	860-621-7389
Fax Number	:	860-621-2586

Provider Business Practice Location Address
First Line	:	360-9 NORTH MAIN STREET
Second Line	:	COMMUNITY PHYSICAL THERAPY
City	:	SOUTHINGTON
State	:	CT
Zip	:	06489-2116
Country	:	US
Telephone Number	:	860-621-7389
Fax Number	:	860-621-2586

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	05/07/2010

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