Individual
MARY JENNIFER WOOTTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4989 SHADY BROOKE RUN, MEDINA, OH 44256-8282
(440) 351-1198
Mailing address
4989 SHADY BROOKE RUN, MEDINA, OH 44256-8282
(440) 351-1198
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
07/25/2022
Last updated
07/25/2022
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