Individual
GREG WOOTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
74 E KIMBALLS LN STE 200, DRAPER, UT 84020-5005
(801) 432-2070
Mailing address
1648 W 1320 N, PROVO, UT 84604-2959
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
2793404201
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
UT
Enumeration date
08/12/2015
Last updated
10/14/2020
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