Provider Demographics
NPI:1295199420
Name:SKOWYRA, ALLYSSA FENNELLY (DC)
Entity Type:Individual
Prefix:DR
First Name:ALLYSSA
Middle Name:FENNELLY
Last Name:SKOWYRA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10184 SHEKINAH HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-9436
Mailing Address - Country:US
Mailing Address - Phone:530-798-9988
Mailing Address - Fax:
Practice Address - Street 1:155 SPRING HILL DR STE 201
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945
Practice Address - Country:US
Practice Address - Phone:530-798-9988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-13
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor