Provider Demographics
NPI:1346556479
Name:POTTER, JULIE KATHERINE (DC PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:KATHERINE
Last Name:POTTER
Suffix:
Gender:F
Credentials:DC PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2461 10TH ST STE 11
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-1201
Mailing Address - Country:US
Mailing Address - Phone:319-351-4090
Mailing Address - Fax:
Practice Address - Street 1:2461 10TH ST STE 11
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-1201
Practice Address - Country:US
Practice Address - Phone:319-351-4090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA7668111N00000X
WI4470-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor