Individual
NICOLE STANKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
625 LINCOLN AVE, PROFESSIONAL PLAZA SUITE 107, CHARLEROI, PA 15022-2451
(724) 483-4886
(724) 483-0519
Mailing address
625 LINCOLN AVE, PROFESSIONAL PLAZA SUITE 107, CHARLEROI, PA 15022-2451
(724) 483-4886
(724) 483-0519
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT015429
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015935850001
—
PA
Enumeration date
06/30/2006
Last updated
07/09/2007
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