Provider Demographics
NPI:1033355201
Name:BENJAMIN W. ERLANDSON D.C., S.C.
Entity Type:Organization
Organization Name:BENJAMIN W. ERLANDSON D.C., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:W
Authorized Official - Last Name:ERLANDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:608-783-5768
Mailing Address - Street 1:1613 MAIN ST STE 4
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-2888
Mailing Address - Country:US
Mailing Address - Phone:608-783-5768
Mailing Address - Fax:608-783-1506
Practice Address - Street 1:1613 MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-2888
Practice Address - Country:US
Practice Address - Phone:608-783-5768
Practice Address - Fax:608-783-1506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4459012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty