Provider Demographics
NPI:1548322373
Name:STARR, SUSAN H (BS, DC)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:H
Last Name:STARR
Suffix:
Gender:F
Credentials:BS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 JOHNSON FERRY RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-5684
Mailing Address - Country:US
Mailing Address - Phone:770-518-8786
Mailing Address - Fax:770-518-9787
Practice Address - Street 1:2850 JOHNSON FERRY RD
Practice Address - Street 2:SUITE 150
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-5684
Practice Address - Country:US
Practice Address - Phone:770-518-8786
Practice Address - Fax:770-518-9787
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1525111N00000X
CO1490111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA581633670OtherEIN
GA581633670OtherEIN