Individual
BENJAMIN SISIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD, LD
Contact information
Practice address
278 BALABAN CIR, WOODSTOCK, GA 30188-5150
(678) 865-9922
Mailing address
278 BALABAN CIR, WOODSTOCK, GA 30188-5150
(678) 865-9922
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD004467
GA
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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