Individual
MR. RICHARD A EKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1407 E CHERRY ST, VERMILLION, SD 57069-2602
(605) 624-7246
(605) 624-7177
Mailing address
1407 E CHERRY ST, VERMILLION, SD 57069-2602
(605) 624-7246
(605) 624-7177
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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