MEDICARE: SUZANNE D POTTER DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT39542	RI

General Provider Information

NPI Number	:	1104135086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE D POTTER DPT

Provider Business Mailing Address
First Line	:	140 POINT JUDITH RD STE 47
Second Line	:
City	:	NARRAGANSETT
State	:	RI
Zip	:	02882-3477
Country	:	US
Telephone Number	:	401-789-2077
Fax Number	:	877-515-9767

Provider Business Practice Location Address
First Line	:	140 POINT JUDITH RD STE 47
Second Line	:
City	:	NARRAGANSETT
State	:	RI
Zip	:	02882-3477
Country	:	US
Telephone Number	:	401-789-2077
Fax Number	:	877-515-9767

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2010
Last Update Date	:	01/12/2026

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