Provider Demographics
NPI:1609268473
Name:LINNELL, ERIC J
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:J
Last Name:LINNELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 E BELLEVIEW ST
Mailing Address - Street 2:APT 108
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-4599
Mailing Address - Country:US
Mailing Address - Phone:507-995-3284
Mailing Address - Fax:
Practice Address - Street 1:700 TERRACE HTS
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-1321
Practice Address - Country:US
Practice Address - Phone:507-995-3284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-03
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15412255A2300X
MN27502255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer