Individual
MR. SHANE POTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QIDP
Contact information
Practice address
13313 VICTORIA AVE, HUNTINGTON WOODS, MI 48070-1720
(586) 604-5276
Mailing address
13313 VICTORIA AVE, HUNTINGTON WOODS, MI 48070-1720
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/24/2016
Last updated
09/04/2024
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