Individual
MR. JEROME JOSEPH WENNINGER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C MPAS
Contact information
Practice address
7220 S HIGHWAY 16, RAPID CITY, SD 57702-8708
(605) 341-1414
Mailing address
7220 S HIGHWAY 16, RAPID CITY, SD 57702-8708
(605) 341-1414
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0975
SD
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
05/01/2006
Last updated
01/18/2016
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