Basic Information
| Provider Information | |||||||||
| NPI: | 1689154353 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OSTRANDER | ||||||||
| FirstName: | LINDSEY | ||||||||
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| Credential: | COTAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 830 KIRTS BLVD STE 305 | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480844892 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2487602121 | ||||||||
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| Practice Location | |||||||||
| Address1: | 830 KIRTS BLVD STE 305 | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480844892 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2487602121 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2018 | ||||||||
| LastUpdateDate: | 08/21/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224ZE0001X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Environmental Modification |
No ID Information.