Individual
MISS COLETTE WHEELER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17330, 458TH AVE, WATERTOWN, SD 57201
(605) 881-6718
Mailing address
17330, 458TH AVE, WATERTOWN, SD 57201
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0584
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4993792
WELLMARK
SD
Enumeration date
08/24/2007
Last updated
08/24/2007
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