MEDICARE: LAURA RUTH STARR PT

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	225100000X	Physical Therapist	11349	MN

General Provider Information

NPI Number	:	1972857001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA RUTH STARR PT

Provider Business Mailing Address
First Line	:	122 NORTHFIELD ST
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55803-1943
Country	:	US
Telephone Number	:	616-516-0349
Fax Number	:

Provider Business Practice Location Address
First Line	:	122 NORTHFIELD ST
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55803-1943
Country	:	US
Telephone Number	:	616-516-0349
Fax Number	:

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

Provider Enumeration Date	:	10/26/2012
Last Update Date	:	03/09/2026

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