Healthcare Provider Details

I. General information

NPI: 1710924923
Provider Name (Legal Business Name): CLAUDIA B STARR PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W POPLAR ST
ROGERS AR
72756-4242
US

IV. Provider business mailing address

330 CRESTVIEW DR
BENTONVILLE AR
72712-5137
US

V. Phone/Fax

Practice location:
  • Phone: 479-621-8500
  • Fax: 479-621-8506
Mailing address:
  • Phone: 479-619-9851
  • Fax: 479-621-8506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number2626
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: