Provider Demographics
NPI:1124374269
Name:STARR, MICHELLE ELIZABETH (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ELIZABETH
Last Name:STARR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 WILLOW ST
Mailing Address - Street 2:#2
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-1525
Mailing Address - Country:US
Mailing Address - Phone:617-697-9976
Mailing Address - Fax:
Practice Address - Street 1:15 COTTAGE ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-2153
Practice Address - Country:US
Practice Address - Phone:617-697-9976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-26
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3385111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor