Individual
LAWRENCE ROBERT WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3456 21ST AVE S, ST PETERSBURG, FL 33711-3213
(727) 327-1988
Mailing address
5034 3RD AVE N, ST PETERSBURG, FL 33710-8212
(727) 288-1375
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-17645
FL
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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