Organization
WOOTSON HEALTH & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JOSHUA WOOTSON I RD (REGISTERED DIETITIAN)
(609) 379-0196
Entity
Organization
Contact information
Practice address
574 CHELTON AVE, BURLINGTON, NJ 08016-1245
(609) 379-0196
Mailing address
43 MIDDLETON LN, WILLINGBORO, NJ 08046-3127
(609) 379-0196
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
133VN1006X
Metabolic Nutrition Registered Dietitian
—
—
133VN1101X
Gerontological Nutrition Registered Dietitian
—
—
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
—
—
Other
Enumeration date
07/12/2022
Last updated
07/12/2022
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