Individual
LISA M ERICKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
29200 SCHOOLCRAFT RD, LIVONIA, MI 48150-2228
(734) 523-2420
(734) 523-2464
Mailing address
318 WAVERLEY AVE, ROYAL OAK, MI 48067-1339
(124) 822-9149
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601001522
MI
Other
Enumeration date
10/11/2006
Last updated
03/19/2021
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