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D'OVIONNE NYDASIA POTTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
202 CHAPMAN LN, COLUMBIA, TN 38401-2622
(931) 698-8359
Mailing address
2122 CIRCLE DR, COLUMBIA, TN 38401-4430
(931) 490-1480

Taxonomy

Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
TN
320700000X
Physical Disabilities Residential Treatment Facility

Other

Enumeration date
08/19/2019
Last updated
08/19/2019
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