Individual
AMY R STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR-L, BCP
Contact information
Practice address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5011
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5011
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
004820
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
473908226
—
MO
Enumeration date
02/20/2007
Last updated
12/21/2022
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