Provider Demographics
NPI:1942417746
Name:OST, BO THOMAS (LAC, DIPL AC)
Entity Type:Individual
Prefix:
First Name:BO
Middle Name:THOMAS
Last Name:OST
Suffix:
Gender:M
Credentials:LAC, DIPL AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5840 ELLSWORTH AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1712
Mailing Address - Country:US
Mailing Address - Phone:412-512-6066
Mailing Address - Fax:412-894-8146
Practice Address - Street 1:5840 ELLSWORTH AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1712
Practice Address - Country:US
Practice Address - Phone:412-512-6066
Practice Address - Fax:412-894-8146
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK000450L171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist