Provider Demographics
NPI:1891198255
Name:ERLANDSON, JOSEPH
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:ERLANDSON
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 1:700 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WESTBY
Mailing Address - State:WI
Mailing Address - Zip Code:54667-1335
Mailing Address - Country:US
Mailing Address - Phone:608-634-3193
Mailing Address - Fax:608-634-2193
Practice Address - Street 1:700 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTBY
Practice Address - State:WI
Practice Address - Zip Code:54667-1335
Practice Address - Country:US
Practice Address - Phone:608-634-3193
Practice Address - Fax:608-634-2193
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5069111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1205235264Medicare NSC