Individual
MR. MICHAEL STACHECKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
204 WOODLAND DR, SUMMERVILLE, SC 29485-3218
(843) 708-8856
Mailing address
204 WOODLAND DR, SUMMERVILLE, SC 29485-3218
(843) 708-8856
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P47764
SC
Other
Enumeration date
08/12/2015
Last updated
08/12/2015
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