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Individual

ROBERT H. STACK

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
R.PH..

Contact information

Practice address
3 MAPLE ST, KENT, CT 06757-1711
(860) 371-4502
(860) 927-0015
Mailing address
PO BOX 237, WASHINGTON DEPOT, CT 06794-0237
(860) 371-4502
(860) 927-0015

Taxonomy

Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
5558
CT

Other

Enumeration date
06/15/2006
Last updated
07/08/2007
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