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General NPI Number Information
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NPI Number | 1932518040
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Entity Type | Organization
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Legal Business Name | ERICKSEN HEARING SERVICES, LLC
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Dates
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Enumeration Date | 08/04/2014
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Last Update Date | 08/04/2014
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Provider Practice Location Address
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Address Line | 25147 COUNTY ROAD 17
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City | WINONA
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State | MN
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Zip | 55987-5497
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Country | US
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Telephone | 509-279-0251
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Fax | 866-350-0374
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Provider Business Mailing Address
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Address Line | 25147 COUNTY ROAD 17
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City | WINONA
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State | MN
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Zip | 55987-5497
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Country | US
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Telephone | 509-279-0251
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Fax | 866-350-0374
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Authorized Official
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Title or Position | AUDIOLOGIST & CHIEF MANAGER
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Name | TODD ERICKSEN
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Credential | M.A. CCC
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Telephone | 507-279-0251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 5013
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License Number State | MN
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