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Individual
JOHN ROBERT WAITE
Active
Individual
JOHN ROBERT WAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT DPT OCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16820
CA
2251X0800X
Orthopedic Physical Therapist
16820
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01284430
RR MEDICARE
CA
Enumeration date
12/01/2005
Last updated
12/24/2018
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