Individual
EMILY STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1805 ELM ST, CANTON, MO 63435-1685
(573) 288-0355
Mailing address
1805 ELM ST, CANTON, MO 63435-1685
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2014024156
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2014024156
PHARMACIST LICENSE
MO
Enumeration date
11/26/2020
Last updated
11/26/2020
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