BETHANY LYNN STACK

RUTLAND, VT
NPI1184619876
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: VT  055-0030670)
Enumeration Date2005-09-19
Last Update Date2011-03-03
Business Address
-- BETHANY LYNN STACK P.A.
3 ALBERT CREE DR
RUTLAND, VT 05701-4601
Phone number: 802-775-2937
Mailing Address
-- BETHANY LYNN STACK P.A.
3 ALBERT CREE DR
RUTLAND, VT 05701-4601
Phone number: 802-775-2937
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