Healthcare Provider Details

I. General information

NPI: 1386219566
Provider Name (Legal Business Name): ERIC VON FORSBERG I-MD, TND, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2021
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 N REID PL UNIT 311
SIOUX FALLS SD
57103-7092
US

IV. Provider business mailing address

41 W HIGHWAY 14 UNIT 1671
SPEARFISH SD
57783-1148
US

V. Phone/Fax

Practice location:
  • Phone: 530-602-3099
  • Fax:
Mailing address:
  • Phone: 530-602-3099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License NumberA2038449
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number4522253
License Number StateSD
# 3
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: