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Individual

DR. JENNIFER LYNN SABOURIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
1411 32ND ST S, FARGO, ND 58103-6304
(701) 232-2738
(701) 241-4175
Mailing address
1220 2ND AVE S, MOORHEAD, MN 56560-2909
(218) 233-1188
(218) 287-1829

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5028
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30608
BCBS ND
ND
01
350004042
MEDICARE PTAN
MN
01
719563
ACN
MN
01
76L01BE
BCBS MN
MN
05
871622000
MN
Enumeration date
12/05/2007
Last updated
01/31/2017
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