| NPI | 1447807813 |
|---|---|
| Doing Business As | DR. ETHAN SKOG |
| Entity Type | Organization |
| Authorized Contact | ETHAN LEE SKOG Chiropractor 763-496-7871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2020-01-20 |