Individual
DENNIS KIRK SISSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
600 BREEZE PARK DR, WELDON SPRING, MO 63304-9139
(636) 229-5996
(636) 720-3388
Mailing address
26 BROZ RD, BELLFLOWER, MO 63333-2700
(314) 420-8954
(636) 720-3388
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
117159
MO
Other
Enumeration date
11/03/2020
Last updated
11/03/2020
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