Organization
JOHN J. POTENTE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN JOSEPH POTENTE D.C. (PRESIDENT)
(616) 249-1800
Entity
Organization
Contact information
Practice address
3181 PRAIRIE ST SW, SUITE 105, GRANDVILLE, MI 49418-2097
(616) 249-1800
Mailing address
3181 PRAIRIE ST SW, SUITE 105, GRANDVILLE, MI 49418-2097
(616) 249-1800
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2301004828
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
950D152200
BLUE CROSS& BLUE SHIELD
MI
Enumeration date
07/19/2008
Last updated
07/19/2008
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