Provider Demographics
NPI:1790933166
Name:DR. SHEILA FAHEY LTD.
Entity Type:Organization
Organization Name:DR. SHEILA FAHEY LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:MAUREEN
Authorized Official - Last Name:FAHEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-925-5776
Mailing Address - Street 1:3947 EXCELSIOR BLVD
Mailing Address - Street 2:#110
Mailing Address - City:ST. LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416
Mailing Address - Country:US
Mailing Address - Phone:612-925-5776
Mailing Address - Fax:
Practice Address - Street 1:3947 EXCELSIOR BLVD
Practice Address - Street 2:#110
Practice Address - City:ST. LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416
Practice Address - Country:US
Practice Address - Phone:612-925-5776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3378111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty