Healthcare Provider Details

I. General information

NPI: 1447400825
Provider Name (Legal Business Name): ERIC OSCAR FAEHN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 10/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1971 GENEVA AVE N
OAKDALE MN
55128-4108
US

IV. Provider business mailing address

1971 GENEVA AVE N
OAKDALE MN
55128-4108
US

V. Phone/Fax

Practice location:
  • Phone: 612-250-5360
  • Fax: 651-340-1812
Mailing address:
  • Phone: 612-250-5360
  • Fax: 651-340-1812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3125
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: