Individual
MRS. JESSICA LEE WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
93B SPRINGVIEW LN, SUMMERVILLE, SC 29485-8154
(843) 875-4770
Mailing address
100 E HARTWICK LN, GOOSE CREEK, SC 29445-7030
(843) 296-5893
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5108
SC
Other
Enumeration date
02/20/2008
Last updated
02/20/2008
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