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General NPI Number Information
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NPI Number | 1164304507
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Entity Type | Individual
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Provider Name | PHILIP MARK ERLANDSON DC
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Gender | Male
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 1316 BAD AXE CT STE 1
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City | VIROQUA
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State | WI
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Zip | 54665-6143
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Country | US
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Telephone | 608-637-8111
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Fax | 608-637-8722
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Provider Business Mailing Address
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Address Line | 1316 BAD AXE CT
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City | VIROQUA
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State | WI
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Zip | 54665-6143
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Country | US
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Telephone | 608-637-8111
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6328-12
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License Number State | WI
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