| Doctor Name: | JEFF CHARLES ERICKSON |
| NPI Number: | 1578590394 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | PT010007L |
| Business Practice Address: | 1228 Country Club Rd Suite 400 Fairmont, WV - 265542369 |
| Business Phone Number: | 3043660461 |
| Business Fax Number: | 3043660497 |
| Mailing Address: | 943 Maple Dr, MORGANTOWN |
| State: | WV |
| Postal Code: | 265052812 |
| Phone Number: | 3045992515 |
| Fax Number: | 3042853738 |
| NPI Enumeration Date: | 06/27/2006 |
| NPI Last Update Date: | 10/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT010007L |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |