Individual
LAURIE WOOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11680 S 153RD WEST AVE, SAPULPA, OK 74066-8564
(918) 639-4684
Mailing address
11680 S 153RD WEST AVE, SAPULPA, OK 74066-8564
(918) 639-4684
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/05/2025
Last updated
06/05/2025
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