Individual
SAMANTHA STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
N91W15750 FALLS PKWY, MENOMONEE FALLS, WI 53051-2301
(262) 532-1100
Mailing address
1015 5TH AVE, GRAFTON, WI 53024-1801
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1114-39
WI
Other
Enumeration date
07/27/2022
Last updated
07/27/2022
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