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1801430988
WADE STARK
CHAMPAIGN, IL
NPI
1801430988
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor Professional
Enumeration Date
2019-11-01
Last Update Date
2019-11-01
Business Address
WADE STARK
309 W CLARK ST
CHAMPAIGN, IL 61820-4637
Phone number: 217-398-9066
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Mailing Address
WADE STARK
309 W CLARK ST
CHAMPAIGN, IL 61820-4637
Phone number: 217-398-9066
Copy
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