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1144434838
KYLE WIEBESIEK
SIOUX FALLS, SD
NPI
1144434838
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: SD 0185)
Enumeration Date
2007-05-10
Last Update Date
2007-07-08
Business Address
Mr. KYLE WIEBESIEK ATC
810 E 23RD ST
SIOUX FALLS, SD 57105-2135
Phone number: 605-977-6845
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Mailing Address
Mr. KYLE WIEBESIEK ATC
1312 S RISLEY CIR
SIOUX FALLS, SD 57106-3326
Phone number: 605-977-3843
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