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1700544103
NICHOLAS THOMAS SISOFO
SUMMERVILLE, SC
NPI
1700544103
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2021-12-02
Last Update Date
2024-04-30
Business Address
NICHOLAS THOMAS SISOFO PA
709 OLD TROLLEY RD
SUMMERVILLE, SC 29485-5203
Phone number: 843-900-6767
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Mailing Address
NICHOLAS THOMAS SISOFO PA
709 OLD TROLLEY RD
SUMMERVILLE, SC 29485-5203
Phone number:
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