Individual
MARY E SOSTARICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
1301 S MAIN ST, OTTAWA, KS 66067-3537
(630) 352-8638
Mailing address
5809 SILVERSTONE DR, LAWRENCE, KS 66049-8500
(630) 352-8638
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
640
KS
237600000X
Audiologist-Hearing Aid Fitter
771
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014010003
MEDICARE PTAN
KS
05
—
100228600B
—
KS
Enumeration date
08/04/2006
Last updated
11/20/2012
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