Individual
LAURA RAE STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2470 DANIELS BRIDGE RD, BLDG 300, ATHENS, GA 30606-6187
(706) 389-2950
Mailing address
48 S MAIN ST, WATKINSVILLE, GA 30677-7100
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006194
GA
Other
Enumeration date
07/27/2016
Last updated
07/27/2016
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