Individual
NICHOLAS POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
660 S EUCLID AVE, SAINT LOUIS, MO 63110-1010
(314) 454-6000
Mailing address
660 S EUCLID AVE, SAINT LOUIS, MO 63110-1010
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2017021730
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017021730
MISSOURI BOARD OF PHARMACY
MO
Enumeration date
03/13/2019
Last updated
03/13/2019
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