Provider Demographics
NPI:1336511450
Name:OSTROOT, CORY WILLIAM (ND)
Entity type:Individual
Prefix:DR
First Name:CORY
Middle Name:WILLIAM
Last Name:OSTROOT
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 E HAMPTON LN UNIT 102
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-1320
Mailing Address - Country:US
Mailing Address - Phone:619-738-4697
Mailing Address - Fax:
Practice Address - Street 1:1917 E HAMPTON LN UNIT 102
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-1320
Practice Address - Country:US
Practice Address - Phone:619-738-4697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15-1510175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath