Individual
TRACY MARIE POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
640 E SAINT CHARLES RD, CAROL STREAM, IL 60188-3083
(630) 460-4698
Mailing address
640 E SAINT CHARLES RD, CAROL STREAM, IL 60188-3083
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.003873
IL
Other
Enumeration date
10/12/2016
Last updated
10/12/2016
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