Individual
CAROLYN STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
16 ARNOLD ST, WOONSOCKET, RI 02895-2902
(401) 765-2030
(401) 769-7472
Mailing address
22 BIRCHWOOD AVE, GROTON, MA 01450-2078
(978) 448-8405
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT01878
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09519
BC PROVIDER #
RI
Enumeration date
06/26/2006
Last updated
07/08/2007
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