Individual
SUSANA STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3001 S 51ST STREET CT, LINCOLN, NE 68506-3487
(816) 682-7294
Mailing address
3001 S 51ST STREET CT, LINCOLN, NE 68506-3487
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
04/03/2025
Last updated
04/03/2025
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