Provider Demographics
NPI:1811637986
Name:SISU HEALTH LLC
Entity type:Organization
Organization Name:SISU HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:401-269-8524
Mailing Address - Street 1:11230 SAINT MARTINS PKWY
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-3256
Mailing Address - Country:US
Mailing Address - Phone:401-269-8524
Mailing Address - Fax:
Practice Address - Street 1:32071 BEAVER RUN DR STE B
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-1704
Practice Address - Country:US
Practice Address - Phone:410-341-6520
Practice Address - Fax:410-341-6520
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SISU HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty