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NPI Code Detail

MEDICARE: BRYCE ERICKSON PT

MEDICARE:   BRYCE  ERICKSON  PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1108009KS

General Provider Information

NPI Number : 1124992557
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYCE ERICKSON PT
Provider Business Mailing Address
First Line : 2106 W 75TH ST
Second Line :
City : PRAIRIE VILLAGE
State : KS
Zip : 66208-3503
Country : US
Telephone Number : 913-291-2290
Fax Number : 913-291-2449
Provider Business Practice Location Address
First Line : 2106 W 75TH ST
Second Line :
City : PRAIRIE VILLAGE
State : KS
Zip : 66208-3503
Country : US
Telephone Number : 913-291-2290
Fax Number : 913-291-2449
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2025
Last Update Date : 09/30/2025

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Directions to “ BRYCE ERICKSON PT” Practice Location

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