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General NPI Number Information
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NPI Number | 1952927337
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Entity Type | Individual
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Provider Name | BRANDON KEITH OSTROWSKI
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Gender | Male
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Dates
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Enumeration Date | 06/22/2020
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Last Update Date | 06/22/2020
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Provider Practice Location Address
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Address Line | 1001 LAURENCE AVE
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City | JACKSON
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State | MI
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Zip | 49202-2979
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Country | US
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Telephone | 517-740-4777
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Fax |
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Provider Business Mailing Address
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Address Line | 8251 N WALDRON RD
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City | JEROME
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State | MI
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Zip | 49249-9731
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Country | US
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Telephone | 517-581-8892
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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 | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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