Individual
MRS. BETTY SISCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
10012 KENNERLY RD STE 400, SAINT LOUIS, MO 63128-2197
(314) 543-5999
(314) 543-5994
Mailing address
10012 KENNERLY RD STE 400, SAINT LOUIS, MO 63128-2197
(314) 543-5999
(314) 543-5994
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2006036685
MO
Other
Enumeration date
12/11/2006
Last updated
11/28/2022
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