Individual
CARTER JAMES STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
7810 N US HIGHWAY 89, FLAGSTAFF, AZ 86004-6255
(928) 522-8375
Mailing address
1200 N BEAVER ST, ATTN: PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-31271
AZ
Other
Enumeration date
08/07/2020
Last updated
08/22/2023
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