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Individual

JEFFREY RAY STARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
11638 W FLORISSANT AVE, FLORISSANT, MO 63033-6723
(314) 838-8780
(314) 838-8161
Mailing address
11638 W FLORISSANT AVE, FLORISSANT, MO 63033-6723
(314) 838-8780
(314) 838-8161

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6731
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
126371
BLUE CROSS BLUE SHIELD
MO
01
20140300
U.S. DEPT OF LABOR
MO
01
399077
HEALTHLINK
MO
01
627934
ACN
MO
Enumeration date
09/20/2006
Last updated
07/08/2007
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