Individual
MR. NICHOLAS AARON POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
5500 8TH AVE, KENOSHA, WI 53140-3700
(262) 564-0067
(262) 652-1411
Mailing address
5500 8TH AVE, KENOSHA, WI 53140-3700
(262) 564-0067
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
WI
Other
Enumeration date
09/06/2007
Last updated
09/06/2007
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