Provider Demographics
NPI:1902651060
Name:STARR, DANIEL WILLIAM (PT, DPT, CMT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:WILLIAM
Last Name:STARR
Suffix:
Gender:M
Credentials:PT, DPT, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 OAK PARK CIR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-5940
Mailing Address - Country:US
Mailing Address - Phone:319-775-1067
Mailing Address - Fax:
Practice Address - Street 1:2996 7TH AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-3713
Practice Address - Country:US
Practice Address - Phone:319-286-4346
Practice Address - Fax:319-286-4347
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1063842251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic