Individual
KYLE J OSTERBROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3333 BURNET AVE, ML 5037, CINCINNATI, OH 45229-3026
(513) 636-4975
(513) 636-6753
Mailing address
3333 BURNET AVE, ML 5037, CINCINNATI, OH 45229-3026
(513) 636-4975
(513) 636-6753
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.003681RX
OH
363A00000X
Physician Assistant
PA1668
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100221250
—
KY
Enumeration date
08/04/2011
Last updated
05/12/2021
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