IndividualActive
Jacob Ellingson, MSPT, SCS, ATC, CSCS
NPI 1346210432 · Sports Physical Therapist · Mora, MN
Provider details
- NPI number
- 1346210432
- Entity type
- Individual
- Primary specialty
- Sports Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- MSPT, SCS, ATC, CSCS
- Sex
- Male
- Sole proprietor
- No
- License
- 6749 (MN)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
301 Highway 65 S
Mora, MN 55051-1899
Phone: (320) 225-3356
Fax: (320) 225-3370
Approximate (ZIP-level) locationGet directions
Mailing address
301 Highway 65 S
Mora, MN 55051-1899
Registry dates
- Enumerated
- 2006-01-23
- Last updated
- 2014-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.