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1528318631
PETER J. STACK
PROVIDENCE, RI
NPI
1528318631
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2251P0200X Physical Therapist, Pediatrics
(Licence: RI PT00331)
Enumeration Date
2012-09-17
Last Update Date
2013-09-11
Business Address
Mr. PETER J. STACK MSPT
134 THURBERS AVE
PROVIDENCE, RI 02905-4754
Phone number: 401-331-1350
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Mailing Address
Mr. PETER J. STACK MSPT
PO BOX 6688
PROVIDENCE, RI 02940-6688
Phone number: 401-331-1350
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