MEDICARE: DR. SUSAN H STARR B.S., D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1525	GA
2	111N00000X	Chiropractor	1490	CO

General Provider Information

NPI Number	:	1548322373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN H STARR B.S., D.C.

Provider Business Mailing Address
First Line	:	2850 JOHNSON FERRY RD
Second Line	:	SUITE 150
City	:	MARIETTA
State	:	GA
Zip	:	30062-5684
Country	:	US
Telephone Number	:	770-518-8786
Fax Number	:	770-518-9787

Provider Business Practice Location Address
First Line	:	2850 JOHNSON FERRY RD
Second Line	:	SUITE 150
City	:	MARIETTA
State	:	GA
Zip	:	30062-5684
Country	:	US
Telephone Number	:	770-518-8786
Fax Number	:	770-518-9787

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	08/15/2012

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