Individual
MICHELLE WIEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
315 N WASHINGTON STREET, VIBORG, SD 57070-0368
(605) 326-5161
(605) 326-5734
Mailing address
44760 273RD ST, MARION, SD 57043-5501
(605) 297-4240
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0044
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5833640
—
SD
Enumeration date
09/06/2006
Last updated
07/08/2007
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