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Individual

JUSTIN ERICKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7447 EGAN DR STE 203, SAVAGE, MN 55378-2398
(952) 649-2005
(952) 226-5504
Mailing address
7447 EGAN DR STE 203, SAVAGE, MN 55378-2398
(952) 649-2005
(952) 226-5504

Taxonomy

Speciality
Code
Description
License number
State
226300000X
Kinesiotherapist
Primary
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1225347537
MN
Enumeration date
10/05/2010
Last updated
10/05/2010
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