Individual
MADALYN AZELLE POTTERFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 LAKE POTTERFIELD DR, MONROE CITY, MO 63456-1187
(573) 470-9412
Mailing address
3170 HIGHWAY 61, HANNIBAL, MO 63401-6571
(573) 221-5533
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057005150
IL
Other
Enumeration date
06/07/2021
Last updated
06/07/2021
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