Individual
ERIK BRIAN GREGERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11701-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11701-024
TEMP WI LICENSE
WI
Enumeration date
05/26/2011
Last updated
05/26/2011
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