Provider Demographics
NPI:1932294956
Name:SKIBSTED, KIM A II (DC)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:A
Last Name:SKIBSTED
Suffix:II
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 1:1441 29TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1309
Mailing Address - Country:US
Mailing Address - Phone:515-440-3774
Mailing Address - Fax:515-440-3062
Practice Address - Street 1:1441 29TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1309
Practice Address - Country:US
Practice Address - Phone:515-440-3774
Practice Address - Fax:515-440-3062
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA5479111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
08731OtherBCBS OF IOWA
08731OtherBCBS OF IOWA
IAT39695Medicare UPIN