Individual
STACY JEAN WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9669 E 146TH ST STE 165, NOBLESVILLE, IN 46060-5007
(317) 621-6740
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05012633A
IN
Other
Enumeration date
07/07/2015
Last updated
06/22/2021
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