MEDICARE: DR. MICHELLE SABOURIN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	006-0001097	VT

General Provider Information

NPI Number	:	1437361839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE SABOURIN D.C.

Provider Business Mailing Address
First Line	:	1 MILL ST
Second Line	:	SUITE 175
City	:	BURLINGTON
State	:	VT
Zip	:	05401-1530
Country	:	US
Telephone Number	:	802-862-5600
Fax Number	:	802-862-5600

Provider Business Practice Location Address
First Line	:	1 MILL ST
Second Line	:	SUITE 175
City	:	BURLINGTON
State	:	VT
Zip	:	05401-1530
Country	:	US
Telephone Number	:	802-862-5600
Fax Number	:	802-862-5600

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2007
Last Update Date	:	07/08/2007

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