Individual
DR. JASON LEE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
7250 FRANCE AVE S., 300 A, EDINA, MN 55435-4346
(952) 835-4772
(763) 207-8381
Mailing address
7250 FRANCE AVE S, 300A, EDINA, MN 55435-4313
(952) 835-4772
(763) 207-8381
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2301009298
MI
111N00000X
Chiropractor
Primary
4989
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3I335EL
BCBS
MN
01
—
716650
ACN
MN
01
—
CC1343A
CHIROCARE
MN
Enumeration date
02/28/2007
Last updated
10/13/2017
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