Individual provider · Type 1 NPI
Stacy R. Mack
Driver · Rochester, NY
NPI number
1972367696
Active
Practice location
16 Atlee Drive, Lower
Rochester, NY 14626
Mailing address
1370 W Ridge Rd # 1077
Rochester, NY 14615-2418
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Driver Primary | 172A00000X | 365956754 (NY) |
Driver: A person employed to operate a motor vehicle as a carrier of persons or property.
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About NPI 1972367696
Stacy R. Mack's National Provider Identifier is 1972367696, issued on Feb 13, 2024. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Rochester, NY. The record was last updated on Feb 21, 2024.