Provider Demographics
NPI:1942597695
Name:SABOE CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:SABOE CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LAVERNE
Authorized Official - Middle Name:ALDEN
Authorized Official - Last Name:SABOE
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:541-926-3162
Mailing Address - Street 1:915 19TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-4228
Mailing Address - Country:US
Mailing Address - Phone:541-926-3162
Mailing Address - Fax:541-928-2742
Practice Address - Street 1:915 19TH AVE SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-4228
Practice Address - Country:US
Practice Address - Phone:541-926-3162
Practice Address - Fax:541-928-2742
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SABOE CHIROPRACTIC CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1647261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center