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Individual

MIA L ERICKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T., C.H.T.

Contact information

Practice address
3200 E CAMELBACK RD, SUITE 135, PHOENIX, AZ 85018-2311
(602) 954-8473
(602) 954-8494
Mailing address
1860 N 95TH LN, SUITE 105, PHOENIX, AZ 85037-4324
(623) 907-0828
(623) 907-3058

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12364
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0157703000
WV
Enumeration date
02/24/2006
Last updated
01/10/2017
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