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1740821362
LUKE MARCUS EKSTROM
COLUMBUS, GA
NPI
1740821362
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: AL 19-100745)
Enumeration Date
2019-10-04
Last Update Date
2019-10-04
Business Address
LUKE MARCUS EKSTROM
1349 WARREN WILLIAMS RD
COLUMBUS, GA 31901-2630
Phone number: 850-607-6910
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Mailing Address
LUKE MARCUS EKSTROM
3771 STEFANI RD
CANTONMENT, FL 32533-7795
Phone number: 850-607-6910
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