Individual
ELMER G SISNEROS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
10464 S REDWOOD RD, SOUTH JORDAN, UT 84095-8501
(801) 260-1919
Mailing address
PO BOX 1000, DRAPER, UT 84020-1000
(801) 352-9500
(801) 352-9502
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
314098-1206
UT
Other
Enumeration date
04/25/2006
Last updated
07/08/2007
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