Provider Demographics
NPI:1750539003
Name:OSTRANDER, MILISSA K (PT)
Entity type:Individual
Prefix:
First Name:MILISSA
Middle Name:K
Last Name:OSTRANDER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MILISSA
Other - Middle Name:K
Other - Last Name:GARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1244
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:NY
Mailing Address - Zip Code:12413-1244
Mailing Address - Country:US
Mailing Address - Phone:518-622-9200
Mailing Address - Fax:518-622-9945
Practice Address - Street 1:235 MAIN ST
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:NY
Practice Address - Zip Code:12413-1244
Practice Address - Country:US
Practice Address - Phone:518-622-9200
Practice Address - Fax:518-622-9945
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02178812251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic