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General NPI Number Information
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NPI Number | 1053294595
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Entity Type | Organization
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Legal Business Name | JSWOOTEN LLC
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 648 N BUSINESS ROUTE 5
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City | CAMDENTON
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State | MO
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Zip | 65020-2642
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Country | US
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Telephone | 573-836-8633
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Fax |
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Provider Business Mailing Address
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Address Line | 103 BROOKSHIRE LN
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City | CAMDENTON
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State | MO
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Zip | 65020-3802
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Country | US
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Telephone | 925-817-0545
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHANIE TITTLE
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Credential | AUD
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Telephone | 925-817-0545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number |
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License Number State |
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