| Sisofo Health Llc | |
|
709 Old Trolley Rd Summerville SC 29485-5203 | |
| (843) 900-6767 | |
| (843) 285-5916 |
| Full Name | Sisofo Health Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 709 Old Trolley Rd, Summerville, South Carolina |
| Authorized Official Name and Position | Nicholas Sisofo (PHYSICIAN ASSISTANT) |
| Authorized Official Contact | 8439006767 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sisofo Health Llc 709 Old Trolley Rd Summerville SC 29485-5203 Ph: (843) 900-6767 | Sisofo Health Llc 709 Old Trolley Rd Summerville SC 29485-5203 Ph: (843) 900-6767 |
| NPI Number | 1063274041 |
|---|---|
| Provider Enumeration Date | 01/25/2024 |
| Last Update Date | 04/30/2024 |
| Certification Date | 04/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063274041 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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