Provider Demographics
NPI:1356006092
Name:ANDERSON, ERIN (DPT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:MCMANUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1035 BILLS LN
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:MI
Mailing Address - Zip Code:48879-1183
Mailing Address - Country:US
Mailing Address - Phone:517-896-1136
Mailing Address - Fax:
Practice Address - Street 1:1507 WATERFORD PKWY
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879-9630
Practice Address - Country:US
Practice Address - Phone:989-227-5404
Practice Address - Fax:989-227-5415
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501021549225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist