Individual
MR. RICHARD A EKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0923
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4994161
WELLMARK BCBS
SD
05
—
5835180
—
SD
01
—
PT0923
DAKOTACARE
SD
Enumeration date
11/20/2006
Last updated
10/19/2007
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