Individual
AMANDA SISLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
506 HOLLY AVE, LOGAN, WV 25601-3306
(304) 282-5206
Mailing address
PO BOX 112, VERDUNVILLE, WV 25649-0112
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT002680
WV
Other
Enumeration date
11/19/2015
Last updated
11/19/2015
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