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General NPI Number Information
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NPI Number | 1487341749
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Entity Type | Organization
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Legal Business Name | SKARE SPINE AND PERFORMANCE PLLC
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Dates
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Enumeration Date | 04/18/2023
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Last Update Date | 04/29/2023
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Provider Practice Location Address
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Address Line | 1615 BROADWAY AVE N
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City | ROCHESTER
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State | MN
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Zip | 55906-4103
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Country | US
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Telephone | 507-200-0449
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Fax |
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Provider Business Mailing Address
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Address Line | 14621 198TH ST
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City | SPRING VALLEY
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State | MN
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Zip | 55975-3114
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Country | US
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Telephone | 507-421-0096
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Fax |
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Authorized Official
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Title or Position | OWNER, CHIROPRACTOR
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Name | NATHAN SKARE
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Credential | DC
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Telephone | 507-421-0096
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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 |
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License Number State |
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