Individual
DAVID JASON ERICKSON I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T
Contact information
Practice address
36084 CAROLINE LN, POLSON, MT 59860-8442
(406) 880-0568
Mailing address
PO BOX 304, POLSON, MT 59860-0304
(406) 880-0568
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4008
MT
Other
Enumeration date
08/22/2014
Last updated
08/22/2014
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