Individual
MR. JOHN MITCHELL STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2100 EXETER RD, GERMANTOWN, TN 38138-3922
(901) 757-1350
Mailing address
344 HOMEVILLE RD, COLLIERVILLE, TN 38017-2310
(901) 647-5236
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA0000002893
TN
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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