Provider Demographics
NPI:1356566616
Name:WEGRZYN, CATHIE K (RPT)
Entity type:Individual
Prefix:MRS
First Name:CATHIE
Middle Name:K
Last Name:WEGRZYN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:928 FORT STOCKTON DR STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-1893
Mailing Address - Country:US
Mailing Address - Phone:619-543-1470
Mailing Address - Fax:619-543-1421
Practice Address - Street 1:928 FORT STOCKTON DR STE 201
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-1893
Practice Address - Country:US
Practice Address - Phone:619-543-1470
Practice Address - Fax:619-543-1421
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT5127225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist