Provider Demographics
NPI:1679534259
Name:ONSRUD, ERIK JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:JOHN
Last Name:ONSRUD
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 1:404 W 10 1/2 ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WI
Mailing Address - Zip Code:53566-1378
Mailing Address - Country:US
Mailing Address - Phone:608-328-8226
Mailing Address - Fax:608-328-8226
Practice Address - Street 1:404 W 10 1/2 ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-1378
Practice Address - Country:US
Practice Address - Phone:608-328-8226
Practice Address - Fax:608-328-8226
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3475111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38903300Medicaid
WI38903300Medicaid
WIU68097Medicare UPIN