Individual
AUSTIN WEGENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1203 N 13TH ST, NORFOLK, NE 68701-2609
(402) 371-4991
Mailing address
2600 COMPASS RD, GLENVIEW, IL 60026-8001
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1051
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1051
—
NE
Enumeration date
06/19/2019
Last updated
06/19/2019
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