| Doctor Name: | MS. STACI A.G. WIETFELD |
| NPI Number: | 1487802641 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT, OCS |
| License Number: | 6094 |
| Business Practice Address: | 1100 E 21st St Ste 402 Sioux Falls, SD - 571051000 |
| Business Phone Number: | 6053225080 |
| Business Fax Number: | 6053225085 |
| Mailing Address: | 1100 E 21st St Ste 402, SIOUX FALLS |
| State: | SD |
| Postal Code: | 571051000 |
| Phone Number: | 6053225080 |
| Fax Number: | 6053225085 |
| NPI Enumeration Date: | 08/29/2008 |
| NPI Last Update Date: | 08/29/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 6094 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |