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Dr. Jill K Potts

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NPI Number Detailed Information

Provider Information:

Name: Dr. Jill K Potts
Gender: F
Provider License Number If Given: 210694

NPI Information:

NPI: 1245233295
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 7/8/2007

Provider Business Mailing Address:

Address: 335 PARRISH ST
Canandaigua, NY 14424
Phone Number: 5853932845
Fax Number: 5853969275

Provider Business Practice Location Address:

Address: 335 PARRISH ST
Canandaigua, NY 14424
Phone Number: 5853932845
Fax Number: 5853969275

Provider Taxonomy:

Primary: 207R00000X
Secondary (if any):
State: NY

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