IndividualActive
Jason Ellenbecker, OTC
NPI 1518675461 · Orthopedic Assistant · Eagan, MN
Provider details
- NPI number
- 1518675461
- Entity type
- Individual
- Primary specialty
- Orthopedic AssistantTechnologists, Technicians & Other Technical Service Providers
- Credential
- OTC
- Sex
- Male
- Sole proprietor
- No
- License
- 11811 (MN)
Specialties & taxonomies
Technologists, Technicians & Other Technical Service Providers
Practice location
2700 Vikings Cir
Eagan, MN 55121-1002
Phone: (952) 456-7600
Fax: (952) 456-7601
Approximate (ZIP-level) locationGet directions
Mailing address
4200 Dahlberg Dr Ste 300
Golden Valley, MN 55422-4841
Registry dates
- Enumerated
- 2022-11-09
- Last updated
- 2022-11-09
- Certified
- 2022-11-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.