Individual
KRISTI MARIE POTTEBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1202 RIDGE RD, DENISON, IA 51442
(712) 263-6978
Mailing address
818 W 19TH ST, CARROLL, IA 51401-3519
(712) 792-9737
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
00567
IA
Other
Enumeration date
06/28/2007
Last updated
07/08/2007
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