Individual
AARON WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, PA-C
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
P12724
NC
363AS0400X
Surgical Physician Assistant
Primary
0010-09188
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12724
NC LICESNE
NC
Enumeration date
09/29/2010
Last updated
06/26/2019
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