Individual
MRS. MELORA JEAN POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
236 COMMERCE ST, EDDYVILLE, KY 42038-8294
(270) 388-2222
Mailing address
PO BOX 193, EDDYVILLE, KY 42038-0193
(270) 704-0865
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A01504
KY
Other
Enumeration date
04/07/2008
Last updated
04/07/2008
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