Individual
ROBERT WAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.O.C.O
Contact information
Practice address
18140 W PURDUE AVE, WADDELL, AZ 85355-4237
(602) 320-4521
Mailing address
18140 W PURDUE AVE, WADDELL, AZ 85355-4237
(602) 320-4521
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
C15463
AZ
Other
Enumeration date
04/12/2018
Last updated
10/22/2020
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