Individual
DR. COLLEN EDWARD WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
3200 4TH AVE, SAN DIEGO, CA 92103-5716
(260) 414-2109
Mailing address
3220 TYLER ST, CARLSBAD, CA 92008-3053
(260) 414-2109
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
293640
CA
Other
Enumeration date
10/17/2017
Last updated
10/17/2017
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