Provider Demographics
NPI:1235280520
Name:FEALK, DAWN (DC)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:FEALK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11226 GOLD EXPRESS DR
Mailing Address - Street 2:STE 201
Mailing Address - City:GOLD RIVER
Mailing Address - State:CA
Mailing Address - Zip Code:95670-4411
Mailing Address - Country:US
Mailing Address - Phone:916-861-0028
Mailing Address - Fax:916-861-0029
Practice Address - Street 1:11226 GOLD EXPRESS DR
Practice Address - Street 2:STE 201
Practice Address - City:GOLD RIVER
Practice Address - State:CA
Practice Address - Zip Code:95670-4411
Practice Address - Country:US
Practice Address - Phone:916-861-0028
Practice Address - Fax:916-861-0029
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor