Individual
MR. TERENCE KEVIN POTTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT. LLCC
Contact information
Practice address
16 W CROY ST, SUITE K, HAILEY, ID 83333-9700
(208) 450-7665
Mailing address
PO BOX 3943, HAILEY, ID 83333-3943
(208) 450-7665
(208) 578-2052
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
2896
NM
Other
Enumeration date
08/15/2007
Last updated
08/15/2007
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