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Individual
JEFFREY RAY STARK
Active
Individual
JEFFREY RAY STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6731
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126371
BLUE CROSS BLUE SHIELD
MO
01
—
20140300
U.S. DEPT OF LABOR
MO
01
—
399077
HEALTHLINK
MO
01
—
627934
ACN
MO
Enumeration date
09/20/2006
Last updated
07/08/2007
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