Jason Potts

NPI 1326200460 - Counselor - 101Y00000X

NPI Details
NPI 1326200460
Gender Male
Enumeration Date 06/30/2008
Last Updated 06/30/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
504 MICAH DRIVE
BOX DRAWER M
OLNEY IL, 62450-0913, US
Phone (618) 395-4306
Fax (618) 395-4507
Business Location
PO BOX M
504 MICAH DRIVE
OLNEY IL, 62450-0913, US
Phone (618) 395-4306
Fax (618) 395-4507
Toxanomy
Taxonomy Code 101Y00000X
License State
License Number
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According to our database, Mr. Jason Potts NPI is 1326200460, taxonomy code is 101Y00000X Jason Potts physically located at 504 Micah Drive, Olney IL, 62450-0913. NPI Number Jason Potts has the Individual type.

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1326200460 NPI number is provided on an as is basis without warranty of any kind. 1326200460 is maintained by the National Plan & Provider Enumeration System. The contents of Jason Potts are for informational purposes only.