Individual
DR. JON ROBERT WEGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1120 GROVE AVE, RACINE, WI 53405-3028
(262) 637-7917
(262) 637-6786
Mailing address
1120 GROVE AVE, RACINE, WI 53405-3028
(262) 637-7917
(262) 637-6786
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2647
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38594800
—
WI
Enumeration date
09/20/2005
Last updated
03/24/2016
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