Individual
CHARLES WOOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4025 COUNTY ROAD 92, ELMORE, OH 43416-9601
(419) 410-6499
Mailing address
4025 COUNTY ROAD 92, ELMORE, OH 43416-9601
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10722
OH
Other
Enumeration date
12/22/2016
Last updated
12/22/2016
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