Provider Demographics
NPI:1891917043
Name:OSTROSKY, CHRISTY K
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:K
Last Name:OSTROSKY
Suffix:
Gender:F
Credentials:
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 E
Mailing Address - Street 2:300 MYRTLE ST
Mailing Address - City:PIERCE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65723-0305
Mailing Address - Country:US
Mailing Address - Phone:417-476-2555
Mailing Address - Fax:417-476-5213
Practice Address - Street 1:300 MYRTLE ST
Practice Address - Street 2:SCHOOL DIST R6 PIERCE CITY
Practice Address - City:PIERCE CITY
Practice Address - State:MO
Practice Address - Zip Code:65723-0305
Practice Address - Country:US
Practice Address - Phone:417-476-2555
Practice Address - Fax:417-476-5213
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001546225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO473644938Medicaid