Individual
MARK RYAN ECKELKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2024 DORSETT VLG, MARYLAND HEIGHTS, MO 63043-2208
(314) 590-0550
Mailing address
9127 CORAL DR, SAINT LOUIS, MO 63123-4503
(314) 625-0884
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2025005261
MO
Other
Enumeration date
04/04/2025
Last updated
04/04/2025
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