Individual
MRS. DIANE MARIE POTGETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 685-6264
Mailing address
6208 145TH AVE, HOLLAND, MI 49423-8904
(616) 901-1818
(616) 685-8994
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501008928
MI
Other
Enumeration date
03/07/2018
Last updated
03/07/2018
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