Individual
LESLIE A TRCKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
21395 JOHN MILLESS DR, ROGERS, MN 55374-4402
(763) 428-2206
Mailing address
5502 W BROADWAY AVE, CRYSTAL, MN 55428-3508
(763) 287-6500
(763) 287-6544
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44815
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079543700
—
MN
Enumeration date
11/03/2005
Last updated
10/13/2011
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