Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 2032 | SC |
Y | 213ES0000X | Sports Medicine | 2032 | SC |
NPI | 1174052138 |
---|---|
Provider Name | Olivia Sabo |
First Address | Rockwell, NC 28138-6500 |
Second Address | Rockwell, NC 28138-6500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2017 |
Last Update Date | 05/06/2017 |