Individual
MR. CHARLES BRADLEY SISSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2244 E HARMONY RD STE 100, FORT COLLINS, CO 80528-3422
(970) 412-5928
(970) 632-6181
Mailing address
2244 E HARMONY RD STE 100, FORT COLLINS, CO 80528-3422
(970) 412-5928
(970) 632-6181
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
35700
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42708877
—
CO
Enumeration date
06/11/2006
Last updated
04/18/2024
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