Ellis, Leslie

Ellis, Leslie is an sole proprietor health care provider with primary practice located at 155 Radio Dr , Woodbury MN 55125-2619. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Sports Medicine is her primary health care specialty. Ellis, Leslie can be contacted via phone (952) 831-8742.

Contact Information

Primary practice address
155 Radio Dr Woodbury MN 55125-2619
Phone: (952) 831-8742
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207PS0010X 3005091 New York
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Sports Medicine 207PS0010X 68502 Minnesota

Profile Details

NPI number 1568889418
LBN Legal business name Ellis, Leslie
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 27th, 2014
Last updated Jun 13th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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