Provider Information for 1487118402
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LEDJHA EKSTEDT
Sex: Female
NPI: 1487118402
Last Updated: 2019-01-23
Certification Date:
Certification Date:
Details
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NPI | 1487118402 | ||||||||
Enumeration Date | 2019-01-23 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 4101 ARCTIC BLVD STE B ANCHORAGE, AK 99503-5702 United States Phone: 907-770-6081 | Fax: | ||||||||
Primary Practice Address | 4101 ARCTIC BLVD STE B ANCHORAGE, AK 99503-5702 United States Phone: 907-770-6081 | Fax: | ||||||||
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