Individual
MILES POTIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5105 W SHILO AVE, BAKER, LA 70714-4050
(225) 202-0304
Mailing address
5105 W SHILO AVE, BAKER, LA 70714-4050
(225) 202-0304
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000
—
LA
Enumeration date
01/04/2017
Last updated
01/04/2017
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