Individual
JANET STACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
167 EUCLID AVE, WADSWORTH, OH 44281-1502
(330) 715-0165
Mailing address
167 EUCLID AVE, WADSWORTH, OH 44281-1502
(330) 715-0165
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
03/31/2023
Last updated
03/31/2023
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