Individual
HEATHER RENAE STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
600 I ST, PAWNEE CITY, NE 68420-3001
(402) 852-2231
Mailing address
71204 618TH AVE, BURCHARD, NE 68323-4025
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
984
NE
Other
Enumeration date
12/20/2021
Last updated
12/20/2021
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