Individual
DEVON POTLER-JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 793-5000
Mailing address
982 VIRGINIA AVE NE APT 2, ATLANTA, GA 30306-3608
(678) 994-6719
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
—
—
Other
Enumeration date
06/25/2020
Last updated
06/25/2020
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