Individual
STANLEY PROCHASKA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 AVENUE D, PERRYVILLE, MD 21902
(410) 642-2411
Mailing address
128 N LYNBROOK RD, BEL AIR, MD 21014-5418
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R097544
MD
Other
Enumeration date
08/24/2015
Last updated
08/24/2015
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