Provider Demographics
NPI:1629399084
Name:ELLINGSON, RACHEL ANN (DPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:ELLINGSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 RADIO DR STE 220
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-9476
Mailing Address - Country:US
Mailing Address - Phone:651-241-3636
Mailing Address - Fax:651-241-3646
Practice Address - Street 1:1625 RADIO DR STE 220
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-9476
Practice Address - Country:US
Practice Address - Phone:763-236-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist