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Individual

KELLY WOOTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
110 NNPTC CIR, GOOSE CREEK, SC 29445-6314
(843) 794-6402
Mailing address
110 NNPTC CIR, GOOSE CREEK, SC 29445-6314
(843) 794-6402

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3084
SC

Other

Enumeration date
02/09/2015
Last updated
09/16/2025
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