Individual
LEO SILLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1001 E 2ND ST, COUDERSPORT, PA 16915-8161
(814) 274-9300
Mailing address
1001 E 2ND ST, COUDERSPORT, PA 16915-8161
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA052864
PA
Other
Enumeration date
01/30/2007
Last updated
04/02/2021
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