NPI | 1295742948 |
---|---|
Professional Name | GLENN RONALD WAITE |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: ID M-11148) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 8577) |
207Q00000X Family Medicine (Licence: CA A38237) | |
207Q00000X Family Medicine (Licence: CO 23679) | |
2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: CA A38237) | |
2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: CO 23679) | |
2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: NV 8577) | |
Enumeration Date | 2006-08-02 |
Last Update Date | 2014-06-25 |