Individual
JACKQULYN SISK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1110 SERENGETI CT, NORTH LAS VEGAS, NV 89032-7668
(609) 350-3855
Mailing address
1110 SERENGETI CT, NORTH LAS VEGAS, NV 89032-7668
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
06/07/2012
Last updated
06/07/2012
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