Provider Demographics
NPI:1154650729
Name:LANDEN, ERICH JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:ERICH
Middle Name:JOHN
Last Name:LANDEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 W 3RD ST SUITE A
Mailing Address - Street 2:
Mailing Address - City:CHADRON
Mailing Address - State:NE
Mailing Address - Zip Code:69337-2313
Mailing Address - Country:US
Mailing Address - Phone:308-430-3751
Mailing Address - Fax:
Practice Address - Street 1:139 W 3RD ST
Practice Address - Street 2:SUITE A
Practice Address - City:CHADRON
Practice Address - State:NE
Practice Address - Zip Code:69337-2313
Practice Address - Country:US
Practice Address - Phone:308-430-3751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor