| Doctor Name: | LAWRENCE WESLEY WAITE |
| NPI Number: | 1083663967 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 40617 |
| Business Practice Address: | 2110 Evenson Dr Onalaska, WI - 546508772 |
| Business Phone Number: | 6083976678 |
| Business Fax Number: | 6087815576 |
| Mailing Address: | 2110 Evenson Dr, ONALASKA |
| State: | WI |
| Postal Code: | 546508772 |
| Phone Number: | 6083976678 |
| Fax Number: | 6087815576 |
| NPI Enumeration Date: | 05/09/2006 |
| NPI Last Update Date: | 05/18/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204C00000X |
| License Number: | 40617 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |