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Individual

SANDRA KAY POTTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA(ASCP)

Contact information

Practice address
800 E CARPENTER ST, ST. JOHN'S HOSPITAL - DEPARTMENT OF PATHOLOGY, SPRINGFIELD, IL 62769-0001
(217) 544-6464
(217) 757-6032
Mailing address
800 E CARPENTER ST, ST. JOHN'S HOSPITAL - DEPARTMENT OF PATHOLOGY, SPRINGFIELD, IL 62769-0001
(217) 544-6464
(217) 757-6032

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary

Other

Enumeration date
08/26/2008
Last updated
08/26/2008
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