Provider Demographics
NPI:1326386244
Name:FELLENZ, SCOTT CHARLES (DVM)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:CHARLES
Last Name:FELLENZ
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N73W13583 APPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-4426
Mailing Address - Country:US
Mailing Address - Phone:262-253-2255
Mailing Address - Fax:262-253-4095
Practice Address - Street 1:N73W13583 APPLETON AVE
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-4426
Practice Address - Country:US
Practice Address - Phone:262-253-2255
Practice Address - Fax:262-253-4095
Is Sole Proprietor?:No
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2963174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian