Individual
KYLE OSTAPUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
575 W PECOS RD, CHANDLER, AZ 85225-7402
(602) 432-8836
Mailing address
575 W PECOS RD APT 1094, CHANDLER, AZ 85225-7408
(602) 432-8836
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-17817
AZ
Other
Enumeration date
12/04/2021
Last updated
12/04/2021
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