Individual
ROBERT STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15765 KINGSLEY RD., NINILCHIK, AK 99639
(907) 420-4713
Mailing address
PO BOX 39070, NINILCHIK, AK 99639-0070
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/18/2019
Last updated
04/18/2019
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