Individual
MRS. MARY LEE WEGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1101 DORIS ST, WATERTOWN, WI 53098-1101
(920) 261-1111
Mailing address
1101 DORIS ST, WATERTOWN, WI 53098-1101
(920) 261-1111
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
304882
WI
Other
Enumeration date
05/09/2011
Last updated
05/09/2011
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