Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1003149469 |
---|---|
Provider Name | Timothy Starr |
First Address | Newhall, CA 91321-1060 |
Second Address | Woodland Hills, CA 91367-6701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2009 |
Last Update Date | 29/11/2021 |