Individual
TERRENCE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5200 FAIRVIEW BLVD, WYOMING, MN 55092-8013
(651) 982-7843
Mailing address
4770 CENTERVILLE RD APT 320, SAINT PAUL, MN 55127-2312
(320) 429-0547
Taxonomy
Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary
—
—
Other
Enumeration date
05/24/2019
Last updated
05/24/2019
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