Individual
LAWRENCE LOUIS WOLFGANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
501 HOWARD AVE, ALTOONA, PA 16601-4810
(393) 081-4889
Mailing address
PO BOX 3250, WINCHESTER, VA 22604-2450
(540) 678-3588
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA062592
PA
363AM0700X
Medical Physician Assistant
0110011501
VA
363AM0700X
Medical Physician Assistant
Primary
MA062592
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110011501
LICENSE
VA
Enumeration date
08/12/2019
Last updated
01/06/2026
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