Healthcare Provider Details

I. General information

NPI: 1720906654
Provider Name (Legal Business Name): CADEN IDEKER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 SUMMIT ST
YANKTON SD
57078-3338
US

IV. Provider business mailing address

PO BOX 632658
CINCINNATI OH
45263-2658
US

V. Phone/Fax

Practice location:
  • Phone: 605-665-3861
  • Fax:
Mailing address:
  • Phone: 605-624-7246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: