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General NPI Number Information
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NPI Number | 1386795896
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Entity Type | Individual
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Provider Name | MARK POTTER D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/13/2007
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Last Update Date | 01/04/2008
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Provider Practice Location Address
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Address Line | 366 MASSACHUSETTS AVE SUITE 103
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City | ARLINGTON
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State | MA
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Zip | 02474-6733
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Country | US
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Telephone | 781-648-8500
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Fax | 781-648-7171
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Provider Business Mailing Address
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Address Line | 366 MASSACHUSETTS AVE SUITE 103
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City | ARLINGTON
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State | MA
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Zip | 02474-6733
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Country | US
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Telephone | 781-648-8500
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Fax | 781-648-7171
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 921
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License Number State | MA
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