MEDICARE: GREGORY SKALKO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1426	MN

General Provider Information

NPI Number	:	1003886078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY SKALKO

Provider Business Mailing Address
First Line	:	100 3RD AVE SW
Second Line	:
City	:	CHISHOLM
State	:	MN
Zip	:	55719-1732
Country	:	US
Telephone Number	:	218-254-3349
Fax Number	:	218-254-5656

Provider Business Practice Location Address
First Line	:	100 3RD AVE SW
Second Line	:
City	:	CHISHOLM
State	:	MN
Zip	:	55719-1732
Country	:	US
Telephone Number	:	218-254-3349
Fax Number	:	218-254-5656

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	07/08/2007

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Directions to “ GREGORY SKALKO ” Practice Location

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