Individual
LELAND CHARLES POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
20090 POLK ST NW, ELK RIVER, MN 55330-2064
(218) 531-9669
(855) 761-1441
Mailing address
20090 POLK ST NW, ELK RIVER, MN 55330-2064
(218) 531-9669
(855) 761-1441
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
A674180300
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A674180300
MINNESOTA HEALTHCARE PROGRAMS - UMPI
MN
Enumeration date
02/01/2025
Last updated
02/01/2025
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