MEDICARE: DR. CHARLES LAMONT STARR DPT, 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	PT013541	OH

General Provider Information

NPI Number	:	1952827024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES LAMONT STARR DPT, PT

Provider Business Mailing Address
First Line	:	3338 COLUMBUS ST
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-2624
Country	:	US
Telephone Number	:	614-214-5647
Fax Number	:

Provider Business Practice Location Address
First Line	:	3338 COLUMBUS ST
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-2624
Country	:	US
Telephone Number	:	614-594-2400
Fax Number	:	614-594-2401

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

Provider Enumeration Date	:	08/20/2017
Last Update Date	:	03/20/2023

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