Individual
JULIETA B. SISON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
454 MCDOWELL ST, WELCH, WV 24801-2029
(304) 436-8461
Mailing address
5547 CYNTHIA DR, ROANOKE, VA 24018-3809
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
968
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
WV
Enumeration date
06/01/2006
Last updated
07/09/2007
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