Individual
MELISSA ERICSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DAT, LAT
Contact information
Practice address
3365 S 103RD ST, MILWAUKEE, WI 53227-4161
(262) 604-7515
Mailing address
1711 S EAST LN, NEW BERLIN, WI 53146-1502
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002463A
IN
Other
Enumeration date
04/17/2017
Last updated
05/22/2025
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