BLAKE WOOTEN

BROOKINGS, SD
NPI1134608870
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: SD  0681)
Enumeration Date2018-08-13
Last Update Date2021-10-27
Business Address
BLAKE WOOTEN
2820 STANLEY J MARSHALL CENTER
BROOKINGS, SD 57007-1999
Phone number: 623-258-7634
Mailing Address
BLAKE WOOTEN
2409 10TH ST APT 219
BROOKINGS, SD 57006-5530
Phone number:
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