Provider Demographics
NPI:1598460040
Name:SKARE, NATHAN (DC)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:SKARE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14621 198TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55975-3114
Mailing Address - Country:US
Mailing Address - Phone:507-421-0096
Mailing Address - Fax:
Practice Address - Street 1:1615 BROADWAY AVE N
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-4103
Practice Address - Country:US
Practice Address - Phone:507-200-0449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7082111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor