Provider Demographics
NPI:1316152705
Name:STARK, FRANK E (DOCTOR OF CHIROPRACT)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:E
Last Name:STARK
Suffix:
Gender:M
Credentials:DOCTOR OF CHIROPRACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:MO
Mailing Address - Zip Code:64601
Mailing Address - Country:US
Mailing Address - Phone:660-646-4323
Mailing Address - Fax:
Practice Address - Street 1:713 CHERRY ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:MO
Practice Address - Zip Code:64601-2209
Practice Address - Country:US
Practice Address - Phone:660-646-4323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0002871111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0002866Medicare ID - Type Unspecified