Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1647 | OR |
NPI | 1710028782 |
---|---|
Provider Name | Dr. Laverne Alden Saboe JR. |
First Address | Albany, OR 97322-4228 |
Second Address | Albany, OR 97322-4228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2007 |
Last Update Date | 08/07/2007 |