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Individual

DR. ERIC JON GORMANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
12818 LAKE BLVD, LINDSTROM, MN 55045
(651) 257-2300
(651) 257-2333
Mailing address
12818 LAKE BLVD, LINDSTROM, MN 55045
(651) 257-2300
(651) 257-2333

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7016
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
261583971
MEDICARE PTAN
Enumeration date
02/06/2007
Last updated
09/02/2022
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