Organization
ERICKSON EYE CARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENDRA ERICKSON GARBRECHT O.D. (OPTOMETRIST)
(608) 799-4138
Entity
Organization
Contact information
Practice address
2656 W 12TH AVE, FORT MCCOY, WI 54656-5240
(608) 388-5997
Mailing address
N4637 TIMBERCREST DR E, ONALASKA, WI 54650-8623
(608) 799-4138
(608) 781-1590
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3129-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508962879
INDIVIDUAL NPI
IA
01
—
I17029
MEDICARE INDIVIDUAL PIN
IA
01
—
I17050
MEDICARE GROUP PIN
IA
Enumeration date
12/11/2007
Last updated
02/25/2010
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