Individual
MARY STOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2701 SE CONVENIENCE BLVD, SUITE 3, ANKENY, IA 50021-9432
(515) 554-2140
(515) 635-0009
Mailing address
2701 SE CONVENIENCE BLVD, SUITE 3, ANKENY, IA 50021-9432
(515) 554-2140
(515) 635-0009
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
067464
IA
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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