Provider Demographics
NPI:1437378726
Name:POTTER, ALMA CHRISTINE (DC)
Entity Type:Individual
Prefix:DR
First Name:ALMA
Middle Name:CHRISTINE
Last Name:POTTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3367 S SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:MO
Mailing Address - Zip Code:65613-9132
Mailing Address - Country:US
Mailing Address - Phone:417-326-2318
Mailing Address - Fax:471-326-2461
Practice Address - Street 1:3367 S SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613-9132
Practice Address - Country:US
Practice Address - Phone:417-326-2318
Practice Address - Fax:471-326-2461
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2010-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001011376111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000031908Medicare ID - Type Unspecified