Individual
GARRET WEGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5189
(800) 836-7536
Mailing address
317 N BROAD ST APT 519, PHILADELPHIA, PA 19107-1017
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MT230477
PA
Other
Enumeration date
05/17/2024
Last updated
05/17/2024
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