Individual
JORDAN POTTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
3-1866 KAUMUALII HWY, LIHUE, HI 96766-8606
(808) 333-3688
Mailing address
6330 MAKANA RD, KAPAA, HI 96746-9483
(719) 207-2103
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12999
HI
Other
Enumeration date
01/10/2020
Last updated
01/10/2020
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