Individual
DONNIE WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
1341 PARADISE RD, EDENTON, NC 27932-8503
(252) 482-2538
Mailing address
118 BECCA DR, ELIZABETH CITY, NC 27909-7952
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4626
NC
Other
Enumeration date
05/29/2008
Last updated
05/29/2008
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