Individual
JANCY G POTTANAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 24TH ST, FORT LEE, VA 23801-1716
(804) 734-9910
(804) 734-9594
Mailing address
700 24TH ST, FORT LEE, VA 23801-1716
(804) 734-9910
(804) 734-9594
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101263501
VA
Other
Enumeration date
11/30/2006
Last updated
05/04/2022
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