Individual
ERIC JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
102 NORTH STATE STREET, ROCHESTER, WI 53167-0386
(262) 331-4397
Mailing address
PO BOX 386, ROCHESTER, WI 53167-0386
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5627
WI
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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