Provider Demographics
NPI:1295768752
Name:SKALA, GEORGE E (DC)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:E
Last Name:SKALA
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:MAINE COAST CHIROPRACTIC
Mailing Address - Street 2:PO BOX 155
Mailing Address - City:STOCKTON SPRINGS
Mailing Address - State:ME
Mailing Address - Zip Code:04981
Mailing Address - Country:US
Mailing Address - Phone:207-469-8892
Mailing Address - Fax:888-365-3920
Practice Address - Street 1:65 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUCKSPORT
Practice Address - State:ME
Practice Address - Zip Code:04416-4025
Practice Address - Country:US
Practice Address - Phone:207-567-4264
Practice Address - Fax:207-567-4264
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1369111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME187220000Medicaid
ME060720OtherBLUECROSS BLUE SHIELD
MEME0090Medicare ID - Type Unspecified