Organization
ERICKSON CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONLYN JAY ERICKSON D.C. (CHIROPRACTOR)
(701) 873-7677
Entity
Organization
Contact information
Practice address
212 W MAIN ST, BEULAH, ND 58523-6970
(701) 873-7677
(701) 873-7718
Mailing address
212 W MAIN ST, BEULAH, ND 58523-6970
(701) 873-7677
(701) 873-7718
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
583
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0029
MN LH&WF
MN
01
—
12947
BLUE CROSS/BLUE SHIELD OF NORTH DAKOTA
ND
05
—
18346
—
ND
Enumeration date
01/19/2010
Last updated
05/13/2010
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