Provider Demographics
NPI:1215006564
Name:ERLANDSON, KRIS N (DC)
Entity Type:Individual
Prefix:DR
First Name:KRIS
Middle Name:N
Last Name:ERLANDSON
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 1:1316 BAD AXE CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:VIROQUA
Mailing Address - State:WI
Mailing Address - Zip Code:54665-6133
Mailing Address - Country:US
Mailing Address - Phone:608-637-8111
Mailing Address - Fax:608-637-8722
Practice Address - Street 1:1316 BAD AXE CT
Practice Address - Street 2:SUITE A
Practice Address - City:VIROQUA
Practice Address - State:WI
Practice Address - Zip Code:54665-6133
Practice Address - Country:US
Practice Address - Phone:608-637-8111
Practice Address - Fax:608-637-8722
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1769111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38778500Medicaid
WI000075180Medicare ID - Type Unspecified
WI38778500Medicaid