Provider Demographics
NPI:1447335161
Name:WEGENER, NICHOLAS GARRETT (DPT)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:GARRETT
Last Name:WEGENER
Suffix:
Gender:M
Credentials:DPT
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Mailing Address - Street 1:13809 INDUSTRIAL RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-1117
Mailing Address - Country:US
Mailing Address - Phone:402-932-7111
Mailing Address - Fax:402-932-6878
Practice Address - Street 1:13809 INDUSTRIAL RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-1117
Practice Address - Country:US
Practice Address - Phone:402-932-7111
Practice Address - Fax:402-932-6878
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2010-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE27182251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic