MEDICARE: SABO CHIROPRACTIC LLC

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	6053	CO

General Provider Information

NPI Number	:	1972757318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SABO CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	4755 N ACADEMY BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-4255
Country	:	US
Telephone Number	:	719-570-0303
Fax Number	:

Provider Business Practice Location Address
First Line	:	4755 N ACADEMY BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-4255
Country	:	US
Telephone Number	:	719-570-0303
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	DR. BENJAMIN ROBERT SABO
Credential	:	D.C.
Telephone Number	:	719-570-0303

Provider Enumeration Date	:	11/12/2008
Last Update Date	:	11/12/2008

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