Provider Demographics
NPI:1902986425
Name:FELLOWS, CATHLEEN H (DC)
Entity Type:Individual
Prefix:DR
First Name:CATHLEEN
Middle Name:H
Last Name:FELLOWS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:753 S 24TH ST W
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-7406
Mailing Address - Country:US
Mailing Address - Phone:406-656-4500
Mailing Address - Fax:406-656-1377
Practice Address - Street 1:753 S 24TH ST W
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-7406
Practice Address - Country:US
Practice Address - Phone:406-656-4500
Practice Address - Fax:406-656-1377
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT672111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT04015202OtherWORK COMP
MT0160871Medicaid
MT000040303OtherBCBS
MT604062OtherACN
MT0160854Medicaid
MTM000004533OtherMEDICARE PTAN
MT000004533Medicare ID - Type UnspecifiedMEDICARE
MT0160854Medicaid
MT0160871Medicaid