Individual
ROBERT S STASAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 OAK ST, WIND GAP, PA 18091-1638
(610) 863-4604
Mailing address
225 OAK ST, WIND GAP, PA 18091-1638
(610) 863-4604
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT000571B
PA
Other
Enumeration date
10/21/2006
Last updated
07/08/2007
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