Organization
ERICKSON AUTO TRIM, INC.
Active
Other names
Erickson Mobility
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY E KUDINA (OWNER)
(262) 554-1202
Entity
Organization
Contact information
Practice address
2210 LATHROP AVE, RACINE, WI 53405-4137
(262) 554-1202
(262) 554-9232
Mailing address
2210 LATHROP AVE, RACINE, WI 53405-4137
(262) 554-1202
(262) 554-9232
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41565000
—
WI
Enumeration date
12/01/2006
Last updated
06/18/2009
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