Individual
GREGORY LEE WAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
991 ROUTE 19N, SUITE E, WATERFORD, PA 16441
(814) 796-3400
(814) 796-8533
Mailing address
991 ROUTE 19N, SUITE E, WATERFORD, PA 16441
(814) 796-3400
(814) 796-8533
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT008555L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018701660001
—
PA
05
—
1017340310001
—
PA
Enumeration date
01/17/2006
Last updated
06/26/2014
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