Individual
JEFFREY DARL POTHOVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
333 S PINE ST, SPARTANBURG, SC 29302-2622
(864) 515-7580
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6260
SC
Other
Enumeration date
08/06/2010
Last updated
07/25/2016
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