Provider Demographics
NPI:1386949493
Name:FIONA E. FLETCHER D.C. LTD.
Entity type:Organization
Organization Name:FIONA E. FLETCHER D.C. LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FIONA
Authorized Official - Middle Name:ETHEL
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-263-2393
Mailing Address - Street 1:106 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:CANNON FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:55009-2036
Mailing Address - Country:US
Mailing Address - Phone:507-263-2393
Mailing Address - Fax:507-263-4952
Practice Address - Street 1:424 MILL ST W
Practice Address - Street 2:
Practice Address - City:CANNON FALLS
Practice Address - State:MN
Practice Address - Zip Code:55009-2046
Practice Address - Country:US
Practice Address - Phone:507-263-2393
Practice Address - Fax:507-263-4952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3196261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN688213700Medicaid
MN688213700Medicaid