MEDICARE: TAYLOR GABRIELLE FERGUSON LMT

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	225700000X	Massage Therapist	177339	OK

General Provider Information

NPI Number	:	1851272785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR GABRIELLE FERGUSON LMT

Provider Business Mailing Address
First Line	:	2816 NW 57TH ST STE 102
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-7042
Country	:	US
Telephone Number	:	405-500-8874
Fax Number	:

Provider Business Practice Location Address
First Line	:	2816 NW 57TH ST STE 102
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-7042
Country	:	US
Telephone Number	:	405-500-8874
Fax Number	:

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

Provider Enumeration Date	:	09/09/2025
Last Update Date	:	10/24/2025

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