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1467019414
TERRENCE ELLIS
WYOMING, MN
NPI
1467019414
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224Y00000X Clinical Exercise Physiologist
Enumeration Date
2019-05-24
Last Update Date
2019-05-24
Business Address
TERRENCE ELLIS
5200 FAIRVIEW BLVD
WYOMING, MN 55092-8013
Phone number: 651-982-7843
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Mailing Address
TERRENCE ELLIS
4770 CENTERVILLE RD APT 320
SAINT PAUL, MN 55127-2312
Phone number: 320-429-0547
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