Individual
ELLEN LANE POTOKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1012 W ABRIENDO AVE, PUEBLO, CO 81004-1128
(719) 545-2746
(719) 583-4160
Mailing address
41 MONTEBELLO RD, SUITE 200, PUEBLO, CO 81001-1379
(719) 545-2746
(719) 542-9638
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/02/2017
Last updated
03/02/2017
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