Individual
JENNY POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1675 W WESTERN RESERVE RD, APT 6D, POLAND, OH 44514-4504
(304) 694-0180
Mailing address
8060 MARKET ST, YOUNGSTOWN, OH 44512-6241
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.004148
OH
Other
Enumeration date
12/17/2015
Last updated
08/04/2016
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