Individual
DOUGLAS KENJI POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
1632 HOVER ST, LONGMONT, CO 80501-2441
(303) 776-0508
(303) 684-8468
Mailing address
1632 HOVER ST, LONGMONT, CO 80501-2441
(303) 776-0508
(303) 684-8468
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14641
CO
Other
Enumeration date
11/01/2010
Last updated
11/01/2010
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