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Individual

JACOB L ERICKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
191 THEATER RD, ONALASKA, WI 54650
(608) 785-0940
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(608) 785-0940

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
55271
MN
207Q00000X
Family Medicine Physician
64193
WI
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
64193
WI

Other

Enumeration date
06/17/2011
Last updated
06/15/2022
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