Individual
MRS. BRIDGETT M STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17805 BELLFLOWER LN, CARLYLE, IL 62231-2917
(618) 339-2040
Mailing address
17805 BELLFLOWER LN, CARLYLE, IL 62231-2917
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
IL
Other
Enumeration date
04/14/2007
Last updated
07/08/2007
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