MEDICARE: SABOE CHIROPRACTIC CLINIC

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	261Q00000X	Clinic/Center	1647	OR

General Provider Information

NPI Number	:	1942597695
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SABOE CHIROPRACTIC CLINIC

Provider Business Mailing Address
First Line	:	915 19TH AVE SE
Second Line	:
City	:	ALBANY
State	:	OR
Zip	:	97322-4228
Country	:	US
Telephone Number	:	541-926-3162
Fax Number	:	541-928-2742

Provider Business Practice Location Address
First Line	:	915 19TH AVE SE
Second Line	:
City	:	ALBANY
State	:	OR
Zip	:	97322-4228
Country	:	US
Telephone Number	:	541-926-3162
Fax Number	:	541-928-2742

Authorized Official
Title or Position	:	CHIROPRACTIC PHYSICIAN
Name	:	DR. LAVERNE ALDEN SABOE II
Credential	:	DC
Telephone Number	:	541-926-3162

Provider Enumeration Date	:	07/01/2011
Last Update Date	:	07/01/2011

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