Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 1538 | SD |
NPI | 1013325315 |
---|---|
Provider Name | Jodie Wheeler |
First Address | Sioux Falls, SD 57104-7808 |
Second Address | Sioux Falls, SD 57104-7808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2014 |
Last Update Date | 30/07/2014 |