Individual
DR. MARK R ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
161 W WISCONSIN AVE, PEWAUKEE, WI 53072-3467
(262) 349-8424
Mailing address
305 WOODLANDS CT, HARTLAND, WI 53029-2295
(262) 349-8424
Taxonomy
Speciality
Code
Description
License number
State
2251H1300X
Human Factors Physical Therapist
2755-024
WI
2251S0007X
Sports Physical Therapist
2755-024
WI
2251X0800X
Orthopedic Physical Therapist
Primary
2755-024
WI
Other
Enumeration date
06/30/2011
Last updated
06/30/2011
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