| Doctor Name: | DONNA STACK |
| NPI Number: | 1174981435 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | J1-0003428 |
| Business Practice Address: | 4709 Kirkwood Hwy Wilmington, DE - 198085007 |
| Business Phone Number: | 3029989880 |
| Business Fax Number: | 3029987498 |
| Mailing Address: | 119 Professional Ctr, 1265 Wayne Avenue, Suite 308 INDIANA |
| State: | PA |
| Postal Code: | 157013586 |
| Phone Number: | 7248018095 |
| Fax Number: | 7248018147 |
| NPI Enumeration Date: | 02/02/2016 |
| NPI Last Update Date: | 02/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | J1-0003428 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | DE |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |