IAN STACK

PINEHURST, NC
NPI1154590529
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: NC  103480)
Enumeration Date2008-02-29
Last Update Date2008-02-29
Business Address
-- IAN STACK PA
35 MEMORIAL DR
PINEHURST, NC 28374-8708
Phone number: 910-715-7856
Mailing Address
-- IAN STACK PA
126 JAMES CREEK RD
SOUTHERN PINES, NC 28387-6819
Phone number: 910-692-8224
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