Healthcare Provider Details

I. General information

NPI: 1942077177
Provider Name (Legal Business Name): ALEXIS MARUSKA OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2023
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21697 STATE HIGHWAY 56
AUSTIN MN
55912-5830
US

IV. Provider business mailing address

144 GRANDE VALLEY AVE SW UNIT 2124
ROCHESTER MN
55902-3183
US

V. Phone/Fax

Practice location:
  • Phone: 507-857-1160
  • Fax:
Mailing address:
  • Phone: 507-210-8110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number107332
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: