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Individual
MR. LEE RICHARD POTRATZ
Active
Individual
MR. LEE RICHARD POTRATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1402
MN
363A00000X
Physician Assistant
10848
MN
363AS0400X
Surgical Physician Assistant
Primary
10848
MN
Other
Enumeration date
08/22/2005
Last updated
10/04/2019
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