Provider Demographics
NPI:1538288824
Name:FELLOWS CHIROPRACTIC CLINIC INC
Entity Type:Organization
Organization Name:FELLOWS CHIROPRACTIC CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHLEEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:FELLOWS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-656-4500
Mailing Address - Street 1:753 S 24TH ST W
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-7406
Mailing Address - Country:US
Mailing Address - Phone:406-656-4500
Mailing Address - Fax:406-656-1377
Practice Address - Street 1:753 S 24TH ST W
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-7406
Practice Address - Country:US
Practice Address - Phone:406-656-4500
Practice Address - Fax:406-656-1377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000082972Medicare ID - Type Unspecified