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Individual

CARLA POTVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6066 S SHAWNEE ST, AURORA, CO 80015-4585
(720) 351-3559
Mailing address
6066 S SHAWNEE ST, AURORA, CO 80015-4585
(720) 351-3559

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
8034
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8034
LICENSE
CO
Enumeration date
12/17/2014
Last updated
12/17/2014
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