Provider Demographics
NPI:1790049518
Name:OSTROWSKI, ELIZABETH (MS, ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:OSTROWSKI
Suffix:
Gender:F
Credentials:MS, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 MILL ST S
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-4034
Mailing Address - Country:US
Mailing Address - Phone:218-770-3139
Mailing Address - Fax:
Practice Address - Street 1:615 MILL ST S
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2378
Practice Address - Country:US
Practice Address - Phone:218-736-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN24052255A2300X
ND397-102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer