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General NPI Number Information
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NPI Number | 1790609865
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Entity Type | Organization
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Legal Business Name | BOULDER TOP PAIN & SPINE PLLC
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Dates
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Enumeration Date | 08/10/2026
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Last Update Date | 08/10/2026
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Provider Practice Location Address
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Address Line | 2412 MCCALLIE AVE
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City | CHATTANOOGA
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State | TN
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Zip | 37404-3398
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Country | US
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Telephone | 423-698-0221
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Fax |
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Provider Business Mailing Address
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Address Line | 10816 PINE HILL RD
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City | MC DONALD
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State | TN
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Zip | 37353-4045
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Country | US
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Telephone | 303-668-7203
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. CALVIN FESLER
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Credential | MD
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Telephone | 303-668-7203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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