LESLIE ELLIS
Individual Provider (NPI-1)
Active
Emergency Medicine, Sports Medicine
Provider Information
- NPI Number
1568889418- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 155 RADIO DR, WOODBURY, MN, 551252619
- Phone
- (952) 831-8742
Specialties & Taxonomies
Emergency Medicine, Sports Medicine
License: NY #3005091
Student in an Organized Health Care Education/Training Program
Emergency Medicine, Sports Medicine
Primary License: MN #68502
All Addresses
MAILING
8170 33RD AVE S # MS 21110Q
BLOOMINGTON, MN, 554254516