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1104452218
TIFFANY L STARK
FORT STEWART, GA
NPI
1104452218
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2020-03-20
Last Update Date
2020-03-20
Business Address
TIFFANY L STARK PA
1061 HARMON AVE
FORT STEWART, GA 31314-5641
Phone number: 912-435-6633
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Mailing Address
TIFFANY L STARK PA
1108 CREEKSIDE CIR
HINESVILLE, GA 31313-2574
Phone number: 208-283-6535
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