Healthcare Provider Details

I. General information

NPI: 1467300996
Provider Name (Legal Business Name): SIOUX FALLS MENS WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4908 E ROSA PARKS PL
SIOUX FALLS SD
57110-4041
US

IV. Provider business mailing address

4908 E ROSA PARKS PL
SIOUX FALLS SD
57110-4041
US

V. Phone/Fax

Practice location:
  • Phone: 605-600-5454
  • Fax:
Mailing address:
  • Phone: 605-600-5454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JEROD L WOLFF
Title or Position: ADMINISTRATOR
Credential:
Phone: 605-600-5454