Provider Demographics
NPI:1083179592
Name:STARR SPINE PHYSICAL THERAPY AND WELLNESS, LLC
Entity Type:Organization
Organization Name:STARR SPINE PHYSICAL THERAPY AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:LAMONT
Authorized Official - Last Name:STARR
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:614-214-5647
Mailing Address - Street 1:3338 COLUMBUS ST
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-2624
Mailing Address - Country:US
Mailing Address - Phone:614-594-2400
Mailing Address - Fax:614-594-2401
Practice Address - Street 1:3338 COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-2624
Practice Address - Country:US
Practice Address - Phone:614-594-2400
Practice Address - Fax:614-594-2401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-08
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy