Provider Demographics
NPI:1093751083
Name:FIEBIGER CHIROPRACTIC HEALTH CENTER, PC
Entity Type:Organization
Organization Name:FIEBIGER CHIROPRACTIC HEALTH CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:FIEBIGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-232-8200
Mailing Address - Street 1:2553 KIRSTEN LN S
Mailing Address - Street 2:SUITE #207
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-4901
Mailing Address - Country:US
Mailing Address - Phone:701-232-8200
Mailing Address - Fax:701-232-8207
Practice Address - Street 1:2553 KIRSTEN LN S
Practice Address - Street 2:SUITE #207
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-4901
Practice Address - Country:US
Practice Address - Phone:701-232-8200
Practice Address - Fax:701-232-8207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND26695OtherBCBSND JACLYN COST
ND14095OtherBCBSND TODD FIEBIGER
ND18868Medicaid
ND13735OtherBCBSND TANYA FIEBIGER
ND18869Medicaid
ND11881Medicaid
NDU59616Medicare UPIN
NDU88525Medicare UPIN
NDU61515Medicare UPIN
ND18868Medicaid