Lance Matthew Erickson, DC | |
7615 Washington Ave S, Edina, MN 55439-2417 | |
(952) 300-7177 | |
Not Available |
Full Name | Lance Matthew Erickson |
---|---|
Gender | Male |
Speciality | Chiropractor |
Location | 7615 Washington Ave S, Edina, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649849795 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 6698 (Minnesota) | Primary |
Provider Name | Life Clinic Pa |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1023296167 PECOS PAC ID: 5799934857 Enrollment ID: O20121004000421 |
Mailing Address | Practice Location Address |
---|---|
Lance Matthew Erickson, DC 7615 Washington Ave S, Edina, MN 55439-2417 Ph: (952) 300-7177 | Lance Matthew Erickson, DC 7615 Washington Ave S, Edina, MN 55439-2417 Ph: (952) 300-7177 |
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