Individual
MRS. NANCY ANN POTTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
434 INDIANA RD, WEST GARDINER, ME 04345-3377
(207) 582-5096
Mailing address
434 INDIANA RD, WEST GARDINER, ME 04345-3377
(207) 582-5096
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
ALLS1974
ME
Other
Enumeration date
12/20/2006
Last updated
07/09/2007
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