Provider Demographics
NPI:1770856031
Name:FELTEN CHIROPRACTIC PA
Entity Type:Organization
Organization Name:FELTEN CHIROPRACTIC PA
Other - Org Name:HEALTHSOURCE OF APPLE VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:FELTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-429-6480
Mailing Address - Street 1:4315 CLEMSON CIR
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-4818
Mailing Address - Country:US
Mailing Address - Phone:507-429-6480
Mailing Address - Fax:
Practice Address - Street 1:4315 CLEMSON CIR
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-4818
Practice Address - Country:US
Practice Address - Phone:507-429-6480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5438111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty