Provider Demographics
NPI:1679362271
Name:SA INTEGRATIVE HEALTH LLC
Entity type:Organization
Organization Name:SA INTEGRATIVE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:STILLWAGON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:614-905-6449
Mailing Address - Street 1:45 N PAINT ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-3136
Mailing Address - Country:US
Mailing Address - Phone:740-464-8336
Mailing Address - Fax:
Practice Address - Street 1:45 N PAINT ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-3136
Practice Address - Country:US
Practice Address - Phone:740-464-8336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service