Individual
MICHELLE NICOLE POTTRATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1302 E HUNTER AVE, BLOOMINGTON, IN 47401-5106
(317) 966-5666
Mailing address
1302 E HUNTER AVE, BLOOMINGTON, IN 47401-5106
(317) 966-5666
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002317A
IN
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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