Provider Demographics
NPI:1124133665
Name:SABO, STEVEN EUGENE JR (OTRL)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:EUGENE
Last Name:SABO
Suffix:JR
Gender:M
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 1ST AVENUE SOUTH
Mailing Address - Street 2:SUITE C
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-6037
Mailing Address - Country:US
Mailing Address - Phone:319-337-8818
Mailing Address - Fax:319-337-8308
Practice Address - Street 1:1705 1ST AVENUE SOUTH
Practice Address - Street 2:SUITE C
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6037
Practice Address - Country:US
Practice Address - Phone:319-337-8818
Practice Address - Fax:319-337-8308
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAIOWA 00426225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA31169OtherBLUE CROSS BLUE SHIELD
IAI7892Medicare ID - Type Unspecified