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General NPI Number Information
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NPI Number | 1962906792
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Entity Type | Individual
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Provider Name | RORRIE ELIZABETH SISK CMT
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Gender | Female
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Dates
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Enumeration Date | 03/19/2018
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Last Update Date | 03/19/2018
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Provider Practice Location Address
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Address Line | 254 N WASHINGTON ST
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City | FALLS CHURCH
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State | VA
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Zip | 22046-4517
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Country | US
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Telephone | 571-336-2563
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Fax |
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Provider Business Mailing Address
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Address Line | 9411 RAINTREE RD
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City | BURKE
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State | VA
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Zip | 22015-1949
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Country | US
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Telephone | 845-380-2573
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Fax |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 0019014025
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License Number State | VA
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