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General NPI Number Information
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NPI Number | 1679362271
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Entity Type | Organization
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Legal Business Name | SA INTEGRATIVE HEALTH LLC
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 45 N PAINT ST
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-3136
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Country | US
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Telephone | 740-464-8336
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Fax |
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Provider Business Mailing Address
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Address Line | 45 N PAINT ST
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-3136
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Country | US
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Telephone | 740-464-8336
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANGELA STILLWAGON
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Credential | DO
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Telephone | 614-905-6449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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