Individual
RIC DOUGLAS STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
4351 HANA HIGHWAY, HANA, HI 96713
(808) 895-9350
Mailing address
PO BOX 970, HANA, HI 96713-0970
(808) 895-9350
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 722
HI
Other
Enumeration date
12/10/2009
Last updated
12/10/2009
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