Individual
AUDRA LEIGH POTERUCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
640 S 19TH ST STE 100, NEVADA, IA 50201-2902
(515) 382-5413
(515) 382-7107
Mailing address
640 S 19TH ST STE 100, NEVADA, IA 50201-2902
(515) 382-5413
(515) 382-7107
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
DO-05052
IA
207Q00000X
Family Medicine Physician
Primary
DO-05052
IA
Other
Enumeration date
06/17/2016
Last updated
07/16/2019
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