Individual
DREW ALEXANDER POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
4530 CROMWELL CT, LOVES PARK, IL 61111-3915
(815) 742-4392
Mailing address
4530 CROMWELL CT, LOVES PARK, IL 61111-3915
(815) 742-4392
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.004114
IL
Other
Enumeration date
02/25/2015
Last updated
12/16/2015
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