Provider Demographics
NPI:1225460736
Name:FENGER, AMY JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:JEAN
Last Name:FENGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:JEAN
Other - Last Name:SCHILLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 296
Mailing Address - Street 2:115 1ST AVE NW
Mailing Address - City:WINNEBAGO
Mailing Address - State:MN
Mailing Address - Zip Code:56098-0296
Mailing Address - Country:US
Mailing Address - Phone:507-893-4412
Mailing Address - Fax:507-893-4912
Practice Address - Street 1:115 1ST AVE NW
Practice Address - Street 2:
Practice Address - City:WINNEBAGO
Practice Address - State:MN
Practice Address - Zip Code:56098-0296
Practice Address - Country:US
Practice Address - Phone:507-893-4412
Practice Address - Fax:507-893-4912
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5826111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor