Individual
BLAKE WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2820 STANLEY J MARSHALL CENTER, BROOKINGS, SD 57007-1999
(623) 258-7634
Mailing address
2409 10TH ST APT 219, BROOKINGS, SD 57006-5530
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0681
SD
Other
Enumeration date
08/13/2018
Last updated
10/27/2021
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