Provider Demographics
NPI:1063589406
Name:FROLOV, SABRINA MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:SABRINA
Middle Name:MARIE
Last Name:FROLOV
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 520
Mailing Address - Street 2:
Mailing Address - City:MOLALLA
Mailing Address - State:OR
Mailing Address - Zip Code:97038-0520
Mailing Address - Country:US
Mailing Address - Phone:503-829-2662
Mailing Address - Fax:503-829-2663
Practice Address - Street 1:207 S MOLALLA AVE
Practice Address - Street 2:
Practice Address - City:MOLALLA
Practice Address - State:OR
Practice Address - Zip Code:97038
Practice Address - Country:US
Practice Address - Phone:503-829-2662
Practice Address - Fax:503-829-2663
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27 3324111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR022537Medicaid
OR113783Medicare ID - Type UnspecifiedGROUP NUMBER
OR022537Medicaid