Individual
MR. NORMAN SHAWN STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
600 GLEN AVE STE 203, SALISBURY, MD 21804-5250
(410) 749-4154
(410) 860-9583
Mailing address
10429 FOX GLEN DR, BRIDGEVILLE, DE 19933-4562
(302) 628-3514
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A2330
LICENSE #
MD
Enumeration date
08/30/2006
Last updated
09/27/2019
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