Individual
MS. STACI A.G. WIETFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, OCS
Contact information
Practice address
1100 E 21ST ST STE 402, SIOUX FALLS, SD 57105-1000
(605) 322-5080
(605) 322-5085
Mailing address
1100 E 21ST ST STE 402, SIOUX FALLS, SD 57105-1000
(605) 322-5080
(605) 322-5085
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1370
SD
225100000X
Physical Therapist
6094
MN
Other
Enumeration date
08/29/2008
Last updated
08/29/2008
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