Individual
MR. DARYL C WOOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.T.C.
Contact information
Practice address
1755 EL PASEO RD, LAS CRUCES, NM 88001-6011
(505) 527-9409
(505) 527-9767
Mailing address
2522 LOS ALAMOS CT, LAS CRUCES, NM 88011-1657
(505) 522-4949
(505) 527-9767
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
39
NM
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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