Provider Demographics
NPI:1033546452
Name:POTTER, BRITTANY LEE (ATC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LEE
Last Name:POTTER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SAXON DRIVE
Mailing Address - Street 2:MCLANE CENTER
Mailing Address - City:ALFRED
Mailing Address - State:NY
Mailing Address - Zip Code:14802
Mailing Address - Country:US
Mailing Address - Phone:607-871-2031
Mailing Address - Fax:
Practice Address - Street 1:1 SAXON DRIVE
Practice Address - Street 2:MCLANE CENTER
Practice Address - City:ALFRED
Practice Address - State:NY
Practice Address - Zip Code:14802
Practice Address - Country:US
Practice Address - Phone:607-871-2031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY67-0025812255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer