Ericksen, Edward

Ericksen, Edward is an individual health care provider with primary practice located at 1111 Trinity Ln Ste 111 , Bloomington IL 61704-8112. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Ericksen, Edward can be contacted via phone (309) 663-6461.

Contact Information

Primary practice address
1111 Trinity Ln Ste 111 Bloomington IL 61704-8112
Phone: (309) 663-6461
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT.014702 Ohio
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 13706 Wisconsin
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 070027646 Illinois

Profile Details

NPI number 1043610199
LBN Legal business name Ericksen, Edward
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 26th, 2014
Last updated Feb 20th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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