Individual
MRS. SAMANTHA MARIE WEGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
702 10TH AVE NW, DODGE CENTER, MN 55927-9172
(507) 402-3085
Mailing address
702 10TH AVE NW, DODGE CENTER, MN 55927-9172
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1736
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41-0991680
CARE CENTER
—
Enumeration date
08/24/2022
Last updated
08/24/2022
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