Individual
SARA SISCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
609 QUARTER ST, GLADWIN, MI 48624-1941
(989) 246-6490
Mailing address
609 QUARTER ST, GLADWIN, MI 48624-1941
(989) 246-6371
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704213071
MI
Other
Enumeration date
02/05/2014
Last updated
02/21/2014
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