MEDICARE: FELLER CHIROPRACTIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2213	MN

General Provider Information

NPI Number	:	1356406540
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FELLER CHIROPRACTIC

Provider Business Mailing Address
First Line	:	1404 85TH AVE N
Second Line	:
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55444-1416
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1404 85TH AVE N
Second Line	:
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55444-1416
Country	:	US
Telephone Number	:	763-561-6020
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARSHALL FELLER
Credential	:	D.C.
Telephone Number	:	763-561-6020

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	08/22/2020

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Practice Location Address:

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Practice Fax:

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1851569651 — LACHINSKI CHIROPRACTIC, P.A.
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Directions to “FELLER CHIROPRACTIC ” Practice Location

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