Healthcare Provider Details

I. General information

NPI: 1467969576
Provider Name (Legal Business Name): MARTA HELEN OSTLER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2018
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 COFFEEN AVE STE B
SHERIDAN WY
82801-5352
US

IV. Provider business mailing address

800 COFFEEN AVE STE B
SHERIDAN WY
82801-5352
US

V. Phone/Fax

Practice location:
  • Phone: 307-752-8354
  • Fax: 307-466-1237
Mailing address:
  • Phone: 307-752-8354
  • Fax: 307-466-1237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13109
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0622
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: