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1548669039
ROBERT POTTER
PRESCOTT, AZ
NPI
1548669039
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2014-08-20
Last Update Date
2014-08-20
Business Address
-- ROBERT POTTER LASAC
1630 SHOUP ST
PRESCOTT, AZ 86305-1343
Phone number: 928-277-2448
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Mailing Address
-- ROBERT POTTER LASAC
PO BOX 12443
PRESCOTT, AZ 86304-2443
Phone number: 928-380-1526
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