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Individual

MATHEW S SISSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3200 MACCORKLE AVE SE FL 4, CHARLESTON, WV 25304-1227
(304) 388-5590
(304) 388-8238
Mailing address
3200 MACORKLE AVE, 4TH FLOOR, CHARLESTON, WV 25304
(304) 388-5590
(304) 388-8238

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
ED0649A
WV

Other

Enumeration date
04/12/2016
Last updated
07/21/2022
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