Individual
MARY JANE WEGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
1407 SAINT ANDREW ST STE 100, LA CROSSE, WI 54603-2378
(608) 785-6266
Mailing address
W10242 DEER PRINT TRL, BLACK RIVER FALLS, WI 54615-5465
(715) 284-5154
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
2309 - 120
WI
Other
Enumeration date
12/01/2008
Last updated
12/01/2008
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