Individual provider · Type 1 NPI

Bethany Lynn Stack, P.A.

Medical Physician Assistant · Rutland, VT

NPI number 1184619876 Active

Practice location

3 Albert Cree Dr
Rutland, VT 05701-4601

Call (802) 775-2937 Map

Fax (802) 773-0934

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X055-0030670 (VT)

Medical Physician Assistant: Definition to come...

12 other providers at this address

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About NPI 1184619876

Bethany Lynn Stack, P.A.'s National Provider Identifier is 1184619876, issued on Sep 19, 2005. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Rutland, VT. The record was last updated on Mar 3, 2011.