Individual
MR. WALTER MONTGOMERY WOOTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
379 N 500 W, VERNAL, UT 84078-1956
(435) 789-1165
Mailing address
210 W 300 N, # 75-3, ROOSEVELT, UT 84066-2336
(435) 725-7448
(435) 722-9291
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8802245-1206
UT
Other
Enumeration date
09/24/2013
Last updated
01/16/2017
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