Individual
KRYSTAL POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3 E PULTENEY SQ, BATH, NY 14810-1510
(607) 664-2146
Mailing address
3 E PULTENEY SQ, BATH, NY 14810-1510
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
581706
NY
Other
Enumeration date
06/21/2016
Last updated
06/21/2016
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