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General NPI Number Information
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NPI Number | 1235200684
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Entity Type | Individual
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Provider Name | DONALD WAYNE OSTRANDER JR. D.C.
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Gender | Male
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1106 BROADWAY ST
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City | ALEXANDRIA
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State | MN
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Zip | 56308-2643
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Country | US
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Telephone | 320-762-8671
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Fax |
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Provider Business Mailing Address
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Address Line | 20961 S LAKE SHORE DR
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City | GLENWOOD
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State | MN
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Zip | 56334-5007
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Country | US
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Telephone | 320-634-5649
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 002799
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License Number State | MN
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