Individual
MRS. THERESA AMANDA STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
513 E MAIN ST, LOUISVILLE, OH 44641-1421
(330) 875-0888
(330) 875-4922
Mailing address
522 KAYLYNN ST SE, MASSILLON, OH 44646-7060
(330) 834-0427
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
10/29/2007
Last updated
10/29/2007
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