Ira B Potter Psc

NPI #1962401455 in Lackey, Kentucky

Provider Information

NPI Number
1962401455
Entity Type
Organization
Organization Name
Ira B Potter Psc
Primary Specialty
Clinic/Center - Medical Specialty
Enumeration Date
Jul 18, 2005
Last Updated
Mar 21, 2016

Practice Location

Address
77 MILLARD ALLEN DR.
City
Lackey
ZIP Code
41643-0190
Phone
(606) 358-2381

Authorized Official

Name
IRA BLAINE POTTER, MD
Title
PRESIDENT
Phone
(606) 358-2381

Specialties & Taxonomy Codes

Specialty
Physician Assistant
Clinic/Center - Medical SpecialtyMedical Specialty

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