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Individual

DR. ETHAN POTTEBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
15920 HICKMAN RD STE 900, CLIVE, IA 50325-8013
(515) 987-9574
Mailing address
15920 HICKMAN RD STE 900, CLIVE, IA 50325-8013

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
128252
IA

Other

Enumeration date
10/28/2024
Last updated
10/29/2024
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