Matthew Potlock

NPI #1316395338 in Spring, Texas

Provider Information

NPI Number: 1316395338
Entity Type: Individual
Name: Matthew Potlock
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: May 31, 2016
Last Updated: May 31, 2016

Practice Location

Address: 22 JETTY POINT DR
City: Spring
State: Texas
ZIP Code: 77380-2480
Phone: (832) 585-3672

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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