Individual
COREY ALEXANDER STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5801 S TRANSIT RD, LOCKPORT, NY 14094-5811
(716) 727-2018
Mailing address
480 ABERDEEN RD, LEWISTON, NY 14092-1023
(830) 563-7390
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/22/2025
Last updated
05/22/2025
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