Individual
HAILEY DOMINY STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6413 WATERS AVE STE 102, SAVANNAH, GA 31406-2711
(912) 349-6624
(912) 352-4728
Mailing address
6413 WATERS AVE STE 102, SAVANNAH, GA 31406-2711
(912) 349-6624
(912) 352-4728
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12635
GA
Other
Enumeration date
06/29/2020
Last updated
01/31/2025
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