Provider Demographics
NPI:1457579856
Name:GOLICK, ERIN L (PT)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:L
Last Name:GOLICK
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 1:2200 HARVARD RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-2611
Mailing Address - Country:US
Mailing Address - Phone:785-842-0656
Mailing Address - Fax:785-842-0071
Practice Address - Street 1:2200 HARVARD RD
Practice Address - Street 2:SUITE 102
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-2611
Practice Address - Country:US
Practice Address - Phone:785-842-0656
Practice Address - Fax:785-842-0071
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3633225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS176562Medicare ID - Type Unspecified