Provider Demographics
NPI:1659778876
Name:FOELL, JUSTIN REED (DC)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:REED
Last Name:FOELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 CENTRAL AVE S
Mailing Address - Street 2:
Mailing Address - City:VALLEY CITY
Mailing Address - State:ND
Mailing Address - Zip Code:58072-3330
Mailing Address - Country:US
Mailing Address - Phone:701-845-3132
Mailing Address - Fax:701-490-3398
Practice Address - Street 1:201 CENTRAL AVE S
Practice Address - Street 2:
Practice Address - City:VALLEY CITY
Practice Address - State:ND
Practice Address - Zip Code:58072-3330
Practice Address - Country:US
Practice Address - Phone:701-845-3132
Practice Address - Fax:701-490-3398
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND986111N00000X
MN6004111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDN721130Medicare UPIN