Organization
EAGLE VALLEY CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSIN SKOUG DC (OWNER)
(651) 565-4863
Entity
Organization
Contact information
Practice address
176 PEMBROKE AVE S, WABASHA, MN 55981-1243
(651) 565-4863
(651) 565-4893
Mailing address
176 PEMBROKE AVE S, WABASHA, MN 55981-1243
(651) 565-4863
(651) 565-4893
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
4754-012
WI
305S00000X
Point of Service
Primary
5533
MN
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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