Provider Demographics
NPI:1730245424
Name:FEHR, BRETT ANDREW (DC)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:ANDREW
Last Name:FEHR
Suffix:
Gender:M
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:PO BOX 132
Mailing Address - Street 2:
Mailing Address - City:LAURENS
Mailing Address - State:IA
Mailing Address - Zip Code:50554-0132
Mailing Address - Country:US
Mailing Address - Phone:712-841-4572
Mailing Address - Fax:712-841-6572
Practice Address - Street 1:207 WEST OLIVE STREET
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:IA
Practice Address - Zip Code:50554
Practice Address - Country:US
Practice Address - Phone:712-841-4572
Practice Address - Fax:712-841-6572
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06333111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0483081Medicaid
IA0483081Medicaid