Provider Demographics
NPI:1649595935
Name:KNURR, ERICA JEAN (DC)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:JEAN
Last Name:KNURR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 RIVERCREST CT
Mailing Address - Street 2:
Mailing Address - City:MUKWONAGO
Mailing Address - State:WI
Mailing Address - Zip Code:53149-1759
Mailing Address - Country:US
Mailing Address - Phone:262-441-3314
Mailing Address - Fax:
Practice Address - Street 1:435 RIVERCREST CT
Practice Address - Street 2:
Practice Address - City:MUKWONAGO
Practice Address - State:WI
Practice Address - Zip Code:53149-1759
Practice Address - Country:US
Practice Address - Phone:262-441-3314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4596-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor