Provider Demographics
NPI:1659470227
Name:DEMEL, FIONA ETHEL (DC)
Entity Type:Individual
Prefix:DR
First Name:FIONA
Middle Name:ETHEL
Last Name:DEMEL
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 1:424 MILL ST W
Mailing Address - Street 2:
Mailing Address - City:CANNON FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:55009-2046
Mailing Address - Country:US
Mailing Address - Phone:507-263-2393
Mailing Address - Fax:507-263-4952
Practice Address - Street 1:424 MILL ST W
Practice Address - Street 2:
Practice Address - City:CANNON FALLS
Practice Address - State:MN
Practice Address - Zip Code:55009-2046
Practice Address - Country:US
Practice Address - Phone:507-263-2393
Practice Address - Fax:507-263-4952
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3196111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN350001340Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
FMU53442Medicare UPIN