Individual
MRS. CASEY WEGENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7136 S OUTER 364, O FALLON, MO 63368-7756
(636) 561-3277
(636) 561-5280
Mailing address
7136 S OUTER 364, O FALLON, MO 63368-7756
(636) 561-3277
(636) 561-5280
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085005404
IL
363A00000X
Physician Assistant
Primary
2016020646
MO
Other
Enumeration date
04/16/2015
Last updated
08/13/2019
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