Organization
POTTER OPTOMETRY, INC.
Active
Other names
Personal Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROXANNA T POTTER O.D. (PRESIDENT)
(419) 705-5143
Entity
Organization
Contact information
Practice address
8254 MAYBERRY SQ N, SYLVANIA, OH 43560-9457
(419) 885-5300
(419) 885-5308
Mailing address
8006 N BRIDGE WAY, MAUMEE, OH 43537-9495
(419) 885-5300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5738/T2652
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2831467
—
OH
Enumeration date
03/25/2008
Last updated
12/27/2019
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