JACOB ALBERT WOOTEN

LYNCHBURG, VA
NPI1629648209
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: VA  0110008161)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2021-06-28
Last Update Date2021-10-12
Business Address
JACOB ALBERT WOOTEN PA-C
162 MALLARD LN
LYNCHBURG, VA 24502-1154
Phone number: 434-420-1816
Mailing Address
JACOB ALBERT WOOTEN PA-C
162 MALLARD LN
LYNCHBURG, VA 24502-1154
Phone number: 434-420-1816