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Individual

MS. KELLI LYNN POTTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CSFA

Contact information

Practice address
45 W CRYSTAL LAKE ST, SUITE 300, ORLANDO, FL 32806-4435
(407) 254-2549
(407) 849-6882
Mailing address
8736 RANCHO CT, ORLANDO, FL 32836-5831

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
120940

Other

Enumeration date
09/20/2013
Last updated
09/20/2013
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