Individual
AUSTIN TANNER STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1701 N SENATE BLVD # B222, INDIANAPOLIS, IN 46202-1239
(262) 955-0334
Mailing address
2625 N MERIDIAN ST APT 316, INDIANAPOLIS, IN 46208-7703
(262) 955-0334
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26030434A
IN
Other
Enumeration date
09/05/2023
Last updated
09/05/2023
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