Individual
DR. SUSAN STACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1220 N 6 STREET, WAUSAU, WI 54401-1220
(715) 845-7759
(715) 845-4509
Mailing address
1220 N 6 STREET, WAUSAU, WI 54403-1220
(715) 845-7759
(715) 845-4509
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
4828
IL
1223P0300X
Periodontics
Primary
4828
WI
Other
Enumeration date
01/03/2007
Last updated
03/04/2014
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