Organization
SISOFO HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS SISOFO (PHYSICIAN ASSISTANT)
(843) 900-6767
Entity
Organization
Contact information
Practice address
709 OLD TROLLEY RD, SUMMERVILLE, SC 29485-5203
(843) 900-6767
(843) 285-5916
Mailing address
709 OLD TROLLEY RD, SUMMERVILLE, SC 29485-5203
(843) 900-6767
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/25/2024
Last updated
04/30/2024
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