Individual
MELANIE LEITE-CARROLL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6726 CANTERBURY LN, EDEN PRAIRIE, MN 55346-2843
(952) 203-4729
Mailing address
6726 CANTERBURY LN, EDEN PRAIRIE, MN 55346-2843
(952) 203-4729
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4721
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35T43LE
BC/BS
MN
01
—
64-00146
MEDICA
MN
01
—
HP31029
HEALTHPARTNERS
MN
Enumeration date
09/26/2005
Last updated
07/08/2007
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