Healthcare Provider Details

I. General information

NPI: 1770895427
Provider Name (Legal Business Name): JEFFREY EDWARD FEENSTRA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2010
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N MONTANA ST
DILLON MT
59725-3308
US

IV. Provider business mailing address

110 N MONTANA ST
DILLON MT
59725-3308
US

V. Phone/Fax

Practice location:
  • Phone: 406-988-0155
  • Fax:
Mailing address:
  • Phone: 406-988-0155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1237
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number1237
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: