Individual
BILLIE POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
447 WEXFORD CIR, VENICE, FL 34293-4290
(740) 357-6019
Mailing address
447 WEXFORD CIR, P.O. BOX 1312, VENICE, FL 34293-4290
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 10753
FL
Other
Enumeration date
01/20/2012
Last updated
01/20/2012
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