Individual
STEPHEN ALFRED WESSENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA, BS, AS
Contact information
Practice address
10004 204TH AVE E STE 3100, BONNEY LAKE, WA 98391-6540
(253) 987-7509
Mailing address
4709 SHELL BEACH AVE, CHEYENNE, WY 82009-5641
(307) 274-6717
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-1143
WY
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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