Individual
MRS. TERRI LYNN BOGLE WOOTTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
VATL,ATC
Contact information
Practice address
6600 LITTLE FALLS RD, ARLINGTON, VA 22213-1211
(703) 538-3301
Mailing address
10803 PINE ST, FAIRFAX, VA 22030-2821
(703) 279-1554
(703) 279-1554
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126-000001
VA
Other
Enumeration date
11/06/2006
Last updated
07/08/2007
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