Individual
SHANNON POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14235 WACO ST NW, RAMSEY, MN 55303-6175
(763) 228-2450
Mailing address
14235 WACO ST NW, RAMSEY, MN 55303-6175
(763) 228-2450
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/07/2016
Last updated
06/07/2016
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