Individual
VICTORIA STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1498 S SHELDON RD, PLYMOUTH, MI 48170-2140
(734) 890-4627
Mailing address
15608 FLANAGAN ST, ROSEVILLE, MI 48066-1481
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
MI
Other
Enumeration date
10/08/2018
Last updated
08/20/2019
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