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Individual

BURK ROSSITER POTTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
237 26TH ST, OGDEN, UT 84401-3105
(801) 625-3705
(801) 625-3690
Mailing address
237 26TH ST, OGDEN, UT 84401-3105
(801) 625-3705
(801) 625-3690

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5122815-3501
UT

Other

Enumeration date
08/05/2006
Last updated
07/08/2007
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