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Individual

MARTHA VIRGINIA POTTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
35617 FERNWOOD ST, WESTLAND, MI 48186-4107
(734) 968-5360
Mailing address
35617 FERNWOOD ST, WESTLAND, MI 48186-4107
(734) 968-5360

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704225766
MI

Other

Enumeration date
06/14/2021
Last updated
06/14/2021
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