Individual
JASON POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SRNA
Contact information
Practice address
22200 MASONIC BLVD, SAINT CLAIR SHORES, MI 48082-2903
(586) 718-2188
Mailing address
22200 MASONIC BLVD, SAINT CLAIR SHORES, MI 48082-2903
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
4704361966
MI
Other
Enumeration date
04/22/2026
Last updated
04/22/2026
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