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1689237471
PHILLIP STACK
CHARLOTTE, NC
NPI
1689237471
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: NC 2000021342)
Enumeration Date
2019-04-17
Last Update Date
2021-12-16
Business Address
PHILLIP STACK ATC
900 CENTER PARK DR
CHARLOTTE, NC 28217-2961
Phone number: 336-817-9315
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Mailing Address
PHILLIP STACK ATC
1713 SEIFERT CIR
CHARLOTTE, NC 28205-7255
Phone number: 336-817-9315
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