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Individual

MRS. BRITA LARA WEGENER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1540 LAKE ST S, FOREST LAKE, MN 55025-2628
(651) 464-7100
Mailing address
1540 LAKE ST S, FOREST LAKE, MN 55025-2628
(651) 464-7100

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MN

Other

Enumeration date
05/28/2009
Last updated
03/11/2021
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