Individual
KELLY M WIIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
315 W 5TH ST, STORM LAKE, IA 50588-1743
(712) 732-7725
(712) 732-5153
Mailing address
4385 HIGHWAY 20, CORRECTIONVILLE, IA 51016-8028
(712) 732-7725
(712) 732-5153
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
997
IA
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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