Individual
BRYANT WIEKING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
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
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1009
SD
Other
Enumeration date
07/22/2015
Last updated
12/08/2015
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