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Individual

JASON RYAN LEYENDECKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AU.D.

Contact information

Practice address
6444 XERXES AVE S, EDINA, MN 55423-1039
(952) 831-4222
(952) 831-4942
Mailing address
6444 XERXES AVE S, EDINA, MN 55423-1039
(952) 831-4222
(952) 831-4942

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
8450
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8450
STATE OF MINNESOTA LICENSE
MN
Enumeration date
12/06/2010
Last updated
12/06/2010
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