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Individual

TIMOTHY W STARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC DACBSP ICSSD CSCS

Contact information

Practice address
715 13TH AVE E, SUITE 101, WEST FARGO, ND 58078-3380
(701) 492-0696
(701) 492-0696
Mailing address
715 13TH AVE E, SUITE 101, WEST FARGO, ND 58078-3380
(701) 492-0696
(701) 492-0696

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
647
ND

Other

Enumeration date
09/22/2008
Last updated
09/22/2008
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