Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 577-0100 | NH |
NPI | 1174682249 |
---|---|
Provider Name | Dr. Todd W. Erickson |
First Address | Concord, NH 03301-4922 |
Second Address | Concord, NH 03301-4922 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 08/07/2007 |