MEDICARE: MS. LAURA DAWN POTTER AP, DIPL.OM

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	171100000X	Acupuncturist	AP1972	FL

General Provider Information

NPI Number	:	1891752036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA DAWN POTTER AP, DIPL.OM

Provider Business Mailing Address
First Line	:	2916 STAR APPLE CT
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-3618
Country	:	US
Telephone Number	:	727-475-4710
Fax Number	:	888-300-7893

Provider Business Practice Location Address
First Line	:	2907 STATE ROAD 590 STE 6A
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-2505
Country	:	US
Telephone Number	:	727-475-4710
Fax Number	:

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

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	09/12/2024

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