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Contact Information

JASON D ELLENBECKER, OTC
2700 VIKINGS CIR
EAGAN, MN55121-1002
 Phone: 952-456-7600
 Fax: 952-456-7601
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Assistant

246ZX2200X
Indicates primary specialty

NPI Profile & details for JASON D ELLENBECKER · (Male)

NPI # 1518675461
Status Active
Credentials OTC
Entity Individual
Enumeration date 11/09/2022
Last updated 11/09/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 11811
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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