Individual
BRAD WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
3131 TOM AUSTIN HWY, SPRINGFIELD, TN 37172-4801
(615) 382-7979
(615) 382-7909
Mailing address
6 LONGFIELD DR, GREENBRIER, AR 72058-9160
(501) 208-7180
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A781
AR
Other
Enumeration date
03/31/2015
Last updated
03/31/2015
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