Individual
MARK EUGENE WEGENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
23832 ROCKFIELD BLVD STE 160, LAKE FOREST, CA 92630-2820
(949) 465-9500
(949) 465-9506
Mailing address
23832 ROCKFIELD BLVD STE 160, LAKE FOREST, CA 92630-2820
(949) 465-9500
(949) 465-9506
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT24624
CA
2251X0800X
Orthopedic Physical Therapist
Primary
PT24624
CA
Other
Enumeration date
12/18/2006
Last updated
05/24/2018
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