Individual
ANTHONY JOHN STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
3751 ROUND HILL RD, APT 5, SWANSEA, IL 62226-1222
(469) 939-6867
Mailing address
3751 ROUND HILL RD, APT 5, SWANSEA, IL 62226-1222
(469) 939-6867
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2067563
TX
310400000X
Assisted Living Facility
160.005649
IL
314000000X
Skilled Nursing Facility
Primary
2067563
TX
Other
Enumeration date
02/10/2012
Last updated
02/14/2025
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