Provider Demographics
NPI:1952827024
Name:STARR, CHARLES LAMONT (DPT, PT)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:LAMONT
Last Name:STARR
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:614-214-5647
Mailing Address - Fax:
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
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT013541225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist