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General NPI Number Information
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NPI Number | 1275554685
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Entity Type | Individual
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Provider Name | KEVIN ERICKSON P.T.
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 2801 LARKSPUR LANDING CIR
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City | LARKSPUR
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State | CA
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Zip | 94939-1834
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Country | US
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Telephone | 415-461-8233
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Fax | 415-461-6412
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Provider Business Mailing Address
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Address Line | 327 MILLER CREEK RD
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City | SAN RAFAEL
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State | CA
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Zip | 94903-1347
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 24943
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License Number State | CA
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