Individual
DR. JEFF LYLE WOLFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
622 W GRAND XING, MOBRIDGE, SD 57601-2051
(605) 845-5757
Mailing address
622 W GRAND XING, MOBRIDGE, SD 57601-2051
(605) 845-5757
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
710
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7602862
—
SD
Enumeration date
01/29/2006
Last updated
10/12/2012
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