Individual
BRADY STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 831-0150
(417) 447-0570
Mailing address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 831-0150
(417) 447-0570
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2014008807
MO
Other
Enumeration date
03/24/2014
Last updated
01/28/2016
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