Individual
ERICA SHAW WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2470 FLOWOOD DR, FLOWOOD, MS 39232-9019
(877) 554-4257
(601) 983-2839
Mailing address
PO BOX 24537, JACKSON, MS 39225-4537
(877) 554-4257
(601) 983-2839
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA4628
MS
Other
Enumeration date
10/25/2011
Last updated
10/25/2011
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