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NPI Code Detail

MEDICARE: DOUGLAS P OSTRANDER MS, PT

MEDICARE:   DOUGLAS P OSTRANDER  MS, PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist016280NY
2225100000XPhysical Therapist10803AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023012887
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUGLAS P OSTRANDER MS, PT
Provider Business Mailing Address
First Line : 18384 W SUMMERHAVEN DR
Second Line :
City : GOODYEAR
State : AZ
Zip : 85338-5369
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10450 W MCDOWELL RD STE 102
Second Line :
City : AVONDALE
State : AZ
Zip : 85392-4901
Country : US
Telephone Number : 602-648-5444
Fax Number : 602-772-3801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 08/08/2022

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Directions to “ DOUGLAS P OSTRANDER MS, PT” Practice Location

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