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General NPI Number Information
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NPI Number | 1295183812
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Entity Type | Individual
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Provider Name | SOULTANA SUSIE SIOUTIS D.C., CPED
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Gender | Female
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Dates
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Enumeration Date | 05/25/2016
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Last Update Date | 05/25/2016
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Provider Practice Location Address
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Address Line | 251 NELSON STREET
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City | SARNIA
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State | ONTARIO
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Zip | N7T5H9
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Country | CA
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Telephone | 519-383-1304
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Fax | 519-383-0984
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Provider Business Mailing Address
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Address Line | 251 NELSON STREET
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City | SARNIA
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State | ONTARIO
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Zip | N7T5H9
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Country | CA
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Telephone | 519-383-1304
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Fax | 519-383-0984
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3355
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License Number State | ZZ
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