Provider Demographics
NPI:1053294595
Name:JSWOOTEN LLC
Entity type:Organization
Organization Name:JSWOOTEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:925-817-0545
Mailing Address - Street 1:103 BROOKSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:CAMDENTON
Mailing Address - State:MO
Mailing Address - Zip Code:65020-3802
Mailing Address - Country:US
Mailing Address - Phone:925-817-0545
Mailing Address - Fax:
Practice Address - Street 1:648 N BUSINESS ROUTE 5
Practice Address - Street 2:
Practice Address - City:CAMDENTON
Practice Address - State:MO
Practice Address - Zip Code:65020-2642
Practice Address - Country:US
Practice Address - Phone:573-836-8633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332S00000XSuppliersHearing Aid Equipment
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty