Individual
BREANA LEIGH FELLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1420 ALGOMA ST, NEW LONDON, WI 54961-2104
(920) 982-8300
Mailing address
1420 ALGOMA ST, NEW LONDON, WI 54961-2104
(920) 982-8300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
73457
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2018
Last updated
08/18/2021
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