Individual
STACEY VANCOSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
524 E SCOTT ST, OLYPHANT, PA 18447-1966
(570) 766-9497
Mailing address
524 E SCOTT ST, OLYPHANT, PA 18447-1966
(570) 766-9497
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI002342
PA
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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