Individual
ASHLEY STACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNIM
Contact information
Practice address
1926 10TH AVE N, LAKE WORTH, FL 33461-3369
(561) 540-4458
(561) 540-5939
Mailing address
8133 NOVA DR, DAVIE, FL 33324-5709
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
1897
—
Other
Enumeration date
01/05/2010
Last updated
01/05/2010
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