Individual
JACK WEAIR WOOTEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2612 W HEIMAN ST APT D38, NASHVILLE, TN 37208-1818
(615) 686-5212
Mailing address
2612 W HEIMAN ST APT D38, NASHVILLE, TN 37208-1818
(615) 686-5212
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2212
TN
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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