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General NPI Number Information
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NPI Number | 1952533598
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Entity Type | Individual
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Provider Name | AUSTIN W ERICKSON D.C., B.A., B.S.
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Gender | Male
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Dates
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Enumeration Date | 08/16/2009
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 107 EAST OAK STREET
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City | GLENWOOD CITY
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State | WI
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Zip | 54013-0403
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Country | US
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Telephone | 715-246-7500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 403
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City | GLENWOOD CITY
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State | WI
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Zip | 54013-0403
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Country | US
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Telephone | 715-246-7500
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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 | 4506-012
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License Number State | WI
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