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General NPI Number Information
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NPI Number | 1043406515
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Entity Type | Organization
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Legal Business Name | SKABO INC
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 09/27/2007
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Provider Practice Location Address
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Address Line | 1650 N DYSART RD STE #1
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City | GOODYEAR
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State | AZ
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Zip | 85395-1116
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Country | US
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Telephone | 623-925-9045
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Fax | 623-925-9047
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Provider Business Mailing Address
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Address Line | 1650 N DYSART RD STE #1
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City | GOODYEAR
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State | AZ
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Zip | 85395-1116
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Country | US
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Telephone | 623-925-9045
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Fax | 623-925-9047
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES ALLEN SKABO
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Credential | DC
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Telephone | 623-925-9045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 7049
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License Number State | AZ
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