Individual
MRS. BRENNA ANN SANISLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 W OTTLEY AVE, FRUITA, CO 81521-2118
(970) 858-2705
Mailing address
3230 BEECHWOOD ST, GRAND JUNCTION, CO 81506-4833
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/30/2020
Last updated
09/11/2023
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