Provider Demographics
NPI:1427697416
Name:TWO SPARROWS FAMILY CHIROPRACTIC & WELLNESS LLC
Entity type:Organization
Organization Name:TWO SPARROWS FAMILY CHIROPRACTIC & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:FENNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-471-2498
Mailing Address - Street 1:559 EDGEWOOD PL
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-2358
Mailing Address - Country:US
Mailing Address - Phone:406-471-2498
Mailing Address - Fax:
Practice Address - Street 1:559 EDGEWOOD PL
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2358
Practice Address - Country:US
Practice Address - Phone:406-471-2498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-23
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty