Provider Demographics
NPI:1134201940
Name:WOOTTON, STEVEN B (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:B
Last Name:WOOTTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 W MAIN ST STE E
Mailing Address - Street 2:
Mailing Address - City:NEW CONCORD
Mailing Address - State:OH
Mailing Address - Zip Code:43762-1187
Mailing Address - Country:US
Mailing Address - Phone:740-826-4800
Mailing Address - Fax:740-826-4844
Practice Address - Street 1:185 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CONCORD
Practice Address - State:OH
Practice Address - Zip Code:43762-1186
Practice Address - Country:US
Practice Address - Phone:740-826-4800
Practice Address - Fax:740-826-4844
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-01039111N00000X
OH1039111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1760644892OtherMEDICARE
OHT48041Medicare UPIN