ERIC MARC ERLEWINE

SHREVEPORT, LA
NPI1750605622
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy172V00000X Community Health Worker
(Licence: MA  18982)
Enumeration Date2010-03-22
Last Update Date2010-03-22
Business Address
Mr. ERIC MARC ERLEWINE MPT
7330 FERN AVE
SHREVEPORT, LA 71105-4971
Phone number: 304-670-6965
Mailing Address
Mr. ERIC MARC ERLEWINE MPT
101 BRADYS RIDGE RD
WELLSBURG, WV 26070-1901
Phone number: 304-670-6965