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Individual

JACK A FELLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2200 NW 26TH ST, OWATONNA, MN 55060-5503
(507) 451-1120
(507) 444-6287
Mailing address
2200 NW 26TH ST, OWATONNA, MN 55060-5503
(507) 451-1120
(507) 444-6287

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41613
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
151524100
MN
Enumeration date
03/26/2006
Last updated
03/10/2021
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