Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 38MC00118300 | NJ |
NPI | 1104873488 |
---|---|
Provider Name | Dr. Frank A Stiso |
First Address | Colonia, NJ 07067-1822 |
Second Address | Colonia, NJ 07067-1822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 08/07/2007 |