Individual
MRS. SUSAN J POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
710 N 39TH AVE, YAKIMA, WA 98902-6342
(509) 248-4102
Mailing address
1402 CONRAD AVE, YAKIMA, WA 98902-5276
(509) 453-7789
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P1 60040990
WA
Other
Enumeration date
03/09/2011
Last updated
03/09/2011
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