MS. Staci A.g. Wietfeld, DPT, OCS

NPI #1487802641 in Sioux Falls, South Dakota

Provider Information

NPI Number: 1487802641
Entity Type: Individual
Name: MS. Staci A.g. Wietfeld, DPT, OCS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: DPT, OCS
Enumeration Date: Aug 29, 2008
Last Updated: Aug 29, 2008

Practice Location

Address: 1100 E 21ST ST STE 402
City: Sioux Falls
State: South Dakota
ZIP Code: 57105-1000
Phone: (605) 322-5080

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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