Individual
MARISSA G CISNEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
9505 FREDERICKSBURG RD, SAN ANTONIO, TX 78240-4284
(210) 641-6257
Mailing address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2017315
TX
Other
Enumeration date
10/30/2007
Last updated
10/30/2007
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