| Fellows Chiropractic Llc | |
|
8 S State St Preston ID 83263-1243 | |
| (208) 852-2240 | |
| Not Available |
| Full Name | Fellows Chiropractic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8 S State St, Preston, Idaho |
| Authorized Official Name and Position | Douglas Scott Fellows (OWNER) |
| Authorized Official Contact | 2082519925 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fellows Chiropractic Llc 8 S State St Preston ID 83263-1243 Ph: () - | Fellows Chiropractic Llc 8 S State St Preston ID 83263-1243 Ph: (208) 852-2240 |
| NPI Number | 1104291657 |
|---|---|
| Provider Enumeration Date | 12/09/2015 |
| Last Update Date | 06/18/2020 |
| Medicare PECOS PAC ID | 5496181216 |
|---|---|
| Medicare Enrollment ID | O20200213002757 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104291657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | CHIA-1615 (Idaho) | Primary |
| Provider Name | Douglas Scott Fellows |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1215326475 PECOS PAC ID: 7618293416 Enrollment ID: I20150312001891 |
| Provider Name | Jarren Samuel Miller |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1578217352 PECOS PAC ID: 7810373370 Enrollment ID: I20221006001264 |
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