Provider Demographics
NPI:1952927337
Name:OSTROWSKI, BRANDON KEITH
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:KEITH
Last Name:OSTROWSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8251 N WALDRON RD
Mailing Address - Street 2:
Mailing Address - City:JEROME
Mailing Address - State:MI
Mailing Address - Zip Code:49249-9731
Mailing Address - Country:US
Mailing Address - Phone:517-581-8892
Mailing Address - Fax:
Practice Address - Street 1:1001 LAURENCE AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-2979
Practice Address - Country:US
Practice Address - Phone:517-740-4777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other