Individual
KEVIN WEGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
3 COOPER PLZ, SUITE 408, CAMDEN, NJ 08103-1438
(856) 325-6674
(856) 968-8288
Mailing address
1 FEDERAL ST # 200, CAMDEN, NJ 08103-1088
(856) 356-4924
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
46TR00334200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46TR00334200
NJ LICENSE
NJ
Enumeration date
12/13/2011
Last updated
08/24/2022
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