Individual
JESSE R POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
119 GANNETT DR, SOUTH PORTLAND, ME 04106-6942
(207) 773-0040
Mailing address
15 COLD BEAR DR, WINDHAM, ME 04062-3343
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT824
ME
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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