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Individual
WAYNE POTTER
Active
Individual
WAYNE POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
283617
NY
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
11/06/2014
Last updated
11/06/2014
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