Provider Demographics
NPI:1710179361
Name:SKAUFEL, JODELL MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:JODELL
Middle Name:MARIE
Last Name:SKAUFEL
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 1:2525 WILLIAMS DR
Mailing Address - Street 2:#239
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-1900
Mailing Address - Country:US
Mailing Address - Phone:952-895-4071
Mailing Address - Fax:
Practice Address - Street 1:2501 W. 84TH ST.
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-1599
Practice Address - Country:US
Practice Address - Phone:952-888-4777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5009111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor