Healthcare Provider Details

I. General information

NPI: 1184634271
Provider Name (Legal Business Name): ROBERT HAROLD SKOUSON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 BALDWIN RD STE A
LAPEER MI
48446
US

IV. Provider business mailing address

911 BALDWIN RD STE A
LAPEER MI
48446
US

V. Phone/Fax

Practice location:
  • Phone: 810-664-1111
  • Fax: 810-664-7199
Mailing address:
  • Phone: 810-664-1111
  • Fax: 810-664-7199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301008066
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: