Individual
KYLE MATTHEW ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CES
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 672-6000
Mailing address
2489 LYDIA AVE W, ROSEVILLE, MN 55113-1027
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
11/24/2006
Last updated
07/08/2007
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