Provider Demographics
NPI:1558455774
Name:DUEKER, ERIN M (PT)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:M
Last Name:DUEKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1187 N WILLOW AVE STE 103 PMB 100
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-4411
Mailing Address - Country:US
Mailing Address - Phone:559-439-8151
Mailing Address - Fax:559-439-8154
Practice Address - Street 1:7033 N FRESNO ST
Practice Address - Street 2:SUITE 201
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2976
Practice Address - Country:US
Practice Address - Phone:559-439-8151
Practice Address - Fax:559-439-8154
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT23374225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT 233740OtherBLUE SHIELD
CA0PT233740Medicare ID - Type UnspecifiedPHYSICAL THERAPISTS