Individual
JACOB ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1089 GRAND AVE, SAINT PAUL, MN 55105-3002
(651) 797-4834
Mailing address
1089 GRAND AVE, SAINT PAUL, MN 55105-3002
(651) 797-4834
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3571
MN
Other
Enumeration date
06/21/2018
Last updated
03/20/2021
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