ERICA SHAW WOOTEN

FLOWOOD, MS
NPI1548546385
Other NameERICA LATRISHA SHAW
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: MS  PTA4628)
Enumeration Date2011-10-25
Last Update Date2011-10-25
Business Address
-- ERICA SHAW WOOTEN PTA
2470 FLOWOOD DR
FLOWOOD, MS 39232-9019
Phone number: 877-554-4257
Mailing Address
-- ERICA SHAW WOOTEN PTA
PO BOX 24537
JACKSON, MS 39225-4537
Phone number: 877-554-4257