Individual
MARK STACKHOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
373 WALNUT DR, PARKESBURG, PA 19365-1738
(484) 888-2727
Mailing address
373 WALNUT DR, PARKESBURG, PA 19365-1738
(484) 888-2727
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT006031
PA
Other
Enumeration date
12/09/2014
Last updated
12/09/2014
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