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Individual

MR. JEFFREY CHARLES POTERALSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2125 NORTHPOINT BLVD, HIXSON, TN 37343-4072
(423) 875-3376
(423) 875-3451
Mailing address
6115 CALEB PL, OOLTEWAH, TN 37363-6824
(423) 505-2567

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5997
TN
225100000X
Physical Therapist
PT7553
GA
2251X0800X
Orthopedic Physical Therapist
5997
TN

Other

Enumeration date
09/26/2006
Last updated
12/06/2017
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