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Individual
PETER JAMES POTENA
Active
Individual
PETER JAMES POTENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT023681
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DAPT003534
DIRECT ACCESS LICENSE
PA
01
—
PT023681
LICENSE
PA
Enumeration date
07/30/2014
Last updated
09/29/2022
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