Individual
MR. SCOTT ALLEN ERICSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
960 S RAPIDS RD, MANITOWOC, WI 54220-4146
(920) 684-1144
(920) 482-0651
Mailing address
2059 ELVIRA WAY, GREEN BAY, WI 54313-8082
(920) 265-8390
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
418-019
WI
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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