KELSEY MARIE STACK

SYRACUSE, NY
NPI1033344049
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: NY  262832)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2009-05-19
Last Update Date2012-08-31
Business Address
-- KELSEY MARIE STACK D.O.
750 E ADAMS ST
SYRACUSE, NY 13210-2342
Phone number: 315-464-5136
Mailing Address
-- KELSEY MARIE STACK D.O.
2850 LAFAYETTE RD
LA FAYETTE, NY 13084-9529
Phone number: 315-677-8081