Individual
SARAH STACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
709 BLACK BEAR RUN, LAGRANGE, OH 44050
(440) 452-6869
Mailing address
709 BLACK BEAR RUN, LAGRANGE, OH 44050-8808
(440) 452-6869
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
05558
OH
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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