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1659116408
BROCK ALAN WOOTEN
NEWARK, OH
NPI
1659116408
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: OH APRN.CNP.0036699)
Enumeration Date
2024-06-25
Last Update Date
2024-06-25
Business Address
BROCK ALAN WOOTEN
65 MESSIMER DR
NEWARK, OH 43055-1874
Phone number: 740-522-8477
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Mailing Address
BROCK ALAN WOOTEN
165 PROSPECT MOUNT VERNON RD W
WALDO, OH 43356-9116
Phone number: 614-634-0304
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