Individual
HEATHER BROOKE STARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1617 PARK PLACE AVE, #110, FORT WORTH, TX 76110-1300
(817) 921-5020
(817) 921-5022
Mailing address
1617 PARK PLACE AVE, #110, FORT WORTH, TX 76110-1300
(817) 921-5020
(817) 921-5022
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2072768
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149984001
—
TX
05
—
207164901
—
TX
Enumeration date
09/16/2010
Last updated
09/16/2010
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