Individual
KIMBERLY A POTESTIVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1142 S VAN DYKE RD STE 100, BAD AXE, MI 48413-9800
(899) 269-7445
(989) 269-7490
Mailing address
1142 S VAN DYKE RD STE 100, BAD AXE, MI 48413-9800
(989) 926-9874
(899) 269-7490
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3528
AZ
363A00000X
Physician Assistant
Primary
5601005549
MI
Other
Enumeration date
05/22/2007
Last updated
11/27/2024
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