Individual
DEREK POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
379 N 500 W, SUITE 1A, VERNAL, UT 84078-1956
(435) 789-1165
(435) 789-1169
Mailing address
379 N 500 W, SUITE 1A, VERNAL, UT 84078-1956
(435) 789-1165
(435) 789-1169
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8760465-1206
UT
Other
Enumeration date
08/15/2013
Last updated
08/15/2013
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