Potts, Vince A

Potts, Vince A is an individual health care provider with primary practice located at 2755 Mottman Rd Sw , Tumwater WA 98512-5684. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Potts, Vince A can be contacted via phone (360) 352-5077.

Contact Information

Primary practice address
2755 Mottman Rd Sw Tumwater WA 98512-5684
Phone: (360) 352-5077
Fax: (360) 352-5022
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X A160068897 Washington

Profile Details

NPI number 1417189101
LBN Legal business name Potts, Vince A
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2009
Last updated Aug 14th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417189101 NPPES
Washington Other A160068897 STATE LICENSE

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