Individual
JAY VINCENT ELLERBUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1000 W 140TH ST, BURNSVILLE, MN 55337-4480
(952) 808-3000
Mailing address
1000 W 140TH ST, BURNSVILLE, MN 55337-4480
(952) 808-3000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/26/2018
Last updated
09/17/2019
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