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General NPI Number Information
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NPI Number | 1881712339
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Entity Type | Individual
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Provider Name | LARRY M STARR EDD, ATC, LAT, CSCS
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 05/14/2015
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Provider Practice Location Address
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Address Line | 3516 MAHOGANY WAY
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-6047
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Country | US
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Telephone | 954-752-8178
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Fax | 954-752-8348
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Provider Business Mailing Address
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Address Line | 6017 BRIDGEHAVEN DR
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City | MILFORD
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State | OH
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Zip | 45150-5624
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Country | US
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Telephone | 513-630-1518
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Fax | 954-752-8348
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AL 455
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT 000494
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License Number State | OH
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