Provider Demographics
NPI:1285207647
Name:SAHAGUN, FREDDY N (ATC)
Entity Type:Individual
Prefix:
First Name:FREDDY
Middle Name:N
Last Name:SAHAGUN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5984 BLACKBERRY FIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89142-0830
Mailing Address - Country:US
Mailing Address - Phone:702-201-7700
Mailing Address - Fax:
Practice Address - Street 1:5984 BLACKBERRY FIELD AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89142-0830
Practice Address - Country:US
Practice Address - Phone:702-201-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer