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1184619876
BETHANY LYNN STACK
RUTLAND, VT
NPI
1184619876
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: VT 055-0030670)
Enumeration Date
2005-09-19
Last Update Date
2011-03-03
Business Address
-- BETHANY LYNN STACK P.A.
3 ALBERT CREE DR
RUTLAND, VT 05701-4601
Phone number: 802-775-2937
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Mailing Address
-- BETHANY LYNN STACK P.A.
3 ALBERT CREE DR
RUTLAND, VT 05701-4601
Phone number: 802-775-2937
Copy
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