Individual
JUDITH LEIGH WEGEHAUPT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1673 DOUSMAN ST, GREEN BAY, WI 54303-3209
(920) 593-4326
Mailing address
10579 FIELDCREST RD, SISTER BAY, WI 54234-9188
(414) 232-1018
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1836-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255401675
—
WI
Enumeration date
11/09/2006
Last updated
03/12/2010
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