Individual
KIM EMRIN WIEKING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
SD
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0580068
—
IA
01
—
4995624
BCBS
SD
05
—
5830302
—
SD
05
—
802927000
—
MN
Enumeration date
07/25/2006
Last updated
08/20/2020
Update your record
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