Individual
STACY R MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16 ATLEE DRIVE, LOWER, ROCHESTER, NY 14626
(585) 704-0974
Mailing address
1370 W RIDGE RD # 1077, ROCHESTER, NY 14615-2418
(585) 443-6688
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
365956754
NY
Other
Enumeration date
02/13/2024
Last updated
02/21/2024
About Stedi
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