Healthcare Provider Details

I. General information

NPI: 1629967591
Provider Name (Legal Business Name): COLTAN FENSKE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2025
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 2ND AVE SW
CAMBRIDGE MN
55008-1502
US

IV. Provider business mailing address

1407 CARLSON DR
ISANTI MN
55040-8083
US

V. Phone/Fax

Practice location:
  • Phone: 763-645-1114
  • Fax:
Mailing address:
  • Phone: 715-651-8539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7452
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: