Provider Demographics
NPI:1336723535
Name:SKIDMORE, CHLOE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHLOE
Middle Name:
Last Name:SKIDMORE
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 1:2250 N ROCK RD # 118-180
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2331
Mailing Address - Country:US
Mailing Address - Phone:316-290-9224
Mailing Address - Fax:
Practice Address - Street 1:359 N OLD US HIGHWAY 81
Practice Address - Street 2:
Practice Address - City:HESSTON
Practice Address - State:KS
Practice Address - Zip Code:67062-9406
Practice Address - Country:US
Practice Address - Phone:316-290-9224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-12
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-06113111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor