Provider Demographics
NPI:1639150360
Name:SKERGAN, PATRICIA L (DC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:L
Last Name:SKERGAN
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 1:436 S 3RD ST W
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-2520
Mailing Address - Country:US
Mailing Address - Phone:406-728-7777
Mailing Address - Fax:406-549-8352
Practice Address - Street 1:436 S 3RD ST W
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-2520
Practice Address - Country:US
Practice Address - Phone:406-728-7777
Practice Address - Fax:406-549-8352
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT588CHI111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0165295OtherQMB
MT0165308OtherMCD EPSDT
MT4582Medicare ID - Type Unspecified