Individual
MS. SAMANTHA D WOOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3410 MAGNOLIA ST, TEXARKANA, TX 75503-3729
(903) 278-7904
(870) 774-4790
Mailing address
3410 MAGNOLIA ST, TEXARKANA, TX 75503-3729
(903) 278-7904
(870) 774-4790
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2069890
TX
Other
Enumeration date
12/30/2009
Last updated
12/30/2009
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