Individual
STACY L MANROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3897 CAMERON DR NE, LACEY, WA 98516-3888
(973) 826-8080
(866) 309-3354
Mailing address
695 US HIGHWAY 46, SUITE 400A, FAIRFIELD, NJ 07004-1592
(973) 894-1263
(888) 972-3703
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA10003512
WA
Other
Enumeration date
04/15/2016
Last updated
08/16/2016
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