Individual
BREANNA NICOLE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4010 W 65TH ST, EDINA, MN 55435-1706
(952) 456-7000
(952) 456-7001
Mailing address
4200 DAHLBERG DR STE 300, GOLDEN VALLEY, MN 55422-4841
(952) 512-5600
(952) 512-5651
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10887
MN
Other
Enumeration date
08/28/2017
Last updated
10/18/2022
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