Individual
BRIAN LEE POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
6565 W MAIN ST STE 101, KALAMAZOO, MI 49009-9144
(269) 372-1027
(269) 372-2940
Mailing address
6565 W MAIN ST STE 101, KALAMAZOO, MI 49009-9144
(269) 372-1028
(269) 372-2940
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501006208
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326205030
NPI
MI
01
—
5501006208
STATE LICENSE NUMBER
MI
Enumeration date
05/20/2008
Last updated
07/21/2022
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