Healthcare Provider Details

I. General information

NPI: 1013325315
Provider Name (Legal Business Name): JODIE WHEELER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2014
Last Update Date: 07/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 W DOW RUMMEL ST
SIOUX FALLS SD
57104-7808
US

IV. Provider business mailing address

1321 W DOW RUMMEL ST
SIOUX FALLS SD
57104-7808
US

V. Phone/Fax

Practice location:
  • Phone: 605-336-1490
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number1538
License Number StateSD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: