Individual
DR. MARY BETH OSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2280 E 25TH ST, IDAHO FALLS, ID 83404-7542
(208) 227-2100
Mailing address
PO BOX 742358, ATLANTA, GA 30374-2358
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
M5589
ID
Other
Enumeration date
12/26/2006
Last updated
11/20/2020
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