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Individual

JOHN GERALD SIA TIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5714 104TH ST, LUBBOCK, TX 79424-6246
(806) 319-4195
Mailing address
5714 104TH ST, LUBBOCK, TX 79424-6246

Taxonomy

Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
1106656
TX

Other

Enumeration date
09/11/2018
Last updated
09/11/2018
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