Healthcare Provider Details

I. General information

NPI: 1780599092
Provider Name (Legal Business Name): ALLISON FELLNER
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 W 35TH ST
DAVENPORT IA
52806-5827
US

IV. Provider business mailing address

850 43RD AVE STE 100
MOLINE IL
61265-8401
US

V. Phone/Fax

Practice location:
  • Phone: 563-362-0060
  • Fax:
Mailing address:
  • Phone: 309-743-2070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: