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General NPI Number Information
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NPI Number | 1881808848
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Entity Type | Individual
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Provider Name | ERIK DAVID RASMUSON OTR
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Gender | Male
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 516 26TH AVE
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City | MONROE
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State | WI
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Zip | 53566-1531
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Country | US
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Telephone | 608-329-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 5617 POLWORTH ST
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City | FITCHBURG
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State | WI
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Zip | 53711-5485
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 3906026
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License Number State | WI
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