Provider Demographics
NPI:1467969576
Name:OSTLER, MARTA HELEN (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARTA
Middle Name:HELEN
Last Name:OSTLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 525
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:WY
Mailing Address - Zip Code:82836-0525
Mailing Address - Country:US
Mailing Address - Phone:307-461-1795
Mailing Address - Fax:
Practice Address - Street 1:455 BARKER ROAD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:WY
Practice Address - Zip Code:82836
Practice Address - Country:US
Practice Address - Phone:307-461-1795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-10
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT13109225100000X
WY0622225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist