Individual
MR. WADE LOUIS ROBIRTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DT DO
Contact information
Practice address
600 NE SAVANNAH DR STE 2, BEND, OR 97701-4873
(541) 318-7266
(541) 318-4629
Mailing address
600 NE SAVANNAH DR STE 2, BEND, OR 97701-4873
(541) 318-7266
(541) 318-4629
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
DT DO 873997
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129200
—
OR
Enumeration date
05/14/2007
Last updated
07/08/2007
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