Healthcare Provider Details

I. General information

NPI: 1790609865
Provider Name (Legal Business Name): BOULDER TOP PAIN & SPINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2412 MCCALLIE AVE
CHATTANOOGA TN
37404-3398
US

IV. Provider business mailing address

10816 PINE HILL RD
MC DONALD TN
37353-4045
US

V. Phone/Fax

Practice location:
  • Phone: 423-698-0221
  • Fax:
Mailing address:
  • Phone: 303-668-7203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CALVIN FESLER
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 303-668-7203