Individual
GARRETT JAMES FEDDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1525 W 5TH ST, STORM LAKE, IA 50588
(712) 213-8676
Mailing address
1525 WEST 5TH ST PO BOX 309, STORM LAKE, IA 50588
(712) 213-8676
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO-04574
IA
Other
Enumeration date
06/27/2013
Last updated
08/06/2018
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