Individual
ERIC ALLEN EICHLINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
N9402 COUNTY ROAD X, PORTAGE, WI 53901-9462
(608) 981-2045
Mailing address
N9402 HWY X, PORTAGE, WI 53901
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
313582
WI
Other
Enumeration date
05/03/2012
Last updated
05/03/2012
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