Individual
TIFFANY SISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5932 QUEBEC ST STE 180, FORT WORTH, TX 76135-3621
(817) 713-8268
Mailing address
1313 BLANCO CT, BENBROOK, TX 76126-4201
(817) 713-8268
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Enumeration date
05/17/2023
Last updated
05/17/2023
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