Individual
KELLY M POTOCHNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
401 S BALLENGER HWY, ATTN SURGICAL SERVICES, FLINT, MI 48532-3638
(810) 342-4917
(810) 342-1335
Mailing address
401 S BALLENGER HWY, ATTN SURGICAL SERVICES, FLINT, MI 48532-3638
(810) 342-4917
(810) 342-1335
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003490
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00000563
TRAVELERS
MI
Enumeration date
03/16/2006
Last updated
10/09/2012
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