Provider Demographics
NPI:1487834628
Name:SABELLA, DIANA (DC)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:SABELLA
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 1:40576 ORIOLE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BRANCH
Mailing Address - State:MN
Mailing Address - Zip Code:55056-6887
Mailing Address - Country:US
Mailing Address - Phone:651-342-0131
Mailing Address - Fax:651-342-0228
Practice Address - Street 1:823 4TH ST S
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-6248
Practice Address - Country:US
Practice Address - Phone:651-342-0131
Practice Address - Fax:651-342-0228
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4620111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor