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General NPI Number Information
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NPI Number | 1952890980
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Entity Type | Individual
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Provider Name | ANDREW OSTRANDER
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Gender | Male
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Dates
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Enumeration Date | 05/04/2018
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Last Update Date | 05/04/2018
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Provider Practice Location Address
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Address Line | 20961 S LAKESHORE 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 | 320-424-0740
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Fax |
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Provider Business Mailing Address
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Address Line | 20961 S LAKESHORE 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 | 320-424-0740
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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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 60801293
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License Number State | WA
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