Healthcare Provider Details

I. General information

NPI: 1518496702
Provider Name (Legal Business Name): SAA HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 W UNION HILLS DR STE 1400B
GLENDALE AZ
85308-1061
US

IV. Provider business mailing address

6320 W UNION HILLS DR STE 1400B
GLENDALE AZ
85308-1061
US

V. Phone/Fax

Practice location:
  • Phone: 623-688-5400
  • Fax:
Mailing address:
  • Phone: 623-688-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: SHAWN VIGNEAU
Title or Position: SOLE MBR
Credential: DC
Phone: 623-688-5400