Individual
MR. JON D ERIKSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
77 B PEARL ST, ESSEX JCT, VT 05452
(802) 878-5509
(802) 879-1350
Mailing address
PO BOX 14, ESSEX JCT, VT 05453
(802) 878-5509
(802) 879-1350
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0300000265
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OVN1001
—
VT
Enumeration date
04/21/2006
Last updated
08/29/2011
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