Individual
CARTER JACKSON WEGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(701) 540-7603
Mailing address
1021 N INDIAN RIVER DR, COCOA, FL 32922-7532
(701) 540-7603
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/02/2026
Last updated
04/02/2026
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