Provider Demographics
NPI:1235763905
Name:FERRIS, IAN (PT, DPT, ATC, CSCS)
Entity type:Individual
Prefix:
First Name:IAN
Middle Name:
Last Name:FERRIS
Suffix:
Gender:M
Credentials:PT, DPT, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 HAMPSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-1118
Mailing Address - Country:US
Mailing Address - Phone:978-771-6684
Mailing Address - Fax:
Practice Address - Street 1:39 SIMON ST STE 6
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3046
Practice Address - Country:US
Practice Address - Phone:603-417-3976
Practice Address - Fax:603-589-1211
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA37492255A2300X
NH6115225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer