| NPI | 1710291943 |
|---|---|
| Former Name | CHELSEY NICOLE STARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 1604) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 004577) |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2013-03-13 |