Most Relevant Information
Provider Data
| NPI Number: | 1003550047 |
| Provider Name: | KAILIN FERGUSON |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/26/2022 |
| Last Updated: | 04/26/2022 |
Provider Practice Location
12 S CRIM AVE
BELINGTON
WV
262508345
Practice Location Phone/Fax
| Phone: | 3048230223 |
| Fax: |
Provider Mailing Location
PO BOX 92
BELINGTON
WV
262500092
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |