Provider Demographics
NPI:1972683415
Name:SAGGAU, RICHARD ANDREW (DC BCAO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ANDREW
Last Name:SAGGAU
Suffix:
Gender:M
Credentials:DC BCAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 NAVAHO AVENUE, SUITE #26
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001
Mailing Address - Country:US
Mailing Address - Phone:507-625-9060
Mailing Address - Fax:507-625-2350
Practice Address - Street 1:83 NAVAHO AVE
Practice Address - Street 2:SUITE 26
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-4832
Practice Address - Country:US
Practice Address - Phone:507-625-9060
Practice Address - Fax:507-625-2350
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3317111N00000X
IAA05881111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN19G97SAOtherBLUE CROSS BLUE SHIELD
MN507312000Medicaid
MN19G97SAOtherBLUE CROSS BLUE SHIELD
MNU57250Medicare UPIN