Individual
SETH ELLANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
29 CATHERINE LN, LAKE CRYSTAL, MN 56055-2015
(507) 995-7794
Mailing address
29 CATHERINE LN, LAKE CRYSTAL, MN 56055-2015
(507) 995-7794
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/22/2016
Last updated
04/22/2016
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