Provider Demographics
NPI:1477708188
Name:POTENTIAL TECHNOLOGIES
Entity Type:Organization
Organization Name:POTENTIAL TECHNOLOGIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY OF CORPORATION
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DANNER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CNIM
Authorized Official - Phone:828-231-9125
Mailing Address - Street 1:PO BOX 674
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:NC
Mailing Address - Zip Code:28760-0674
Mailing Address - Country:US
Mailing Address - Phone:828-231-9125
Mailing Address - Fax:
Practice Address - Street 1:23 TURTLE CREEK DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3152
Practice Address - Country:US
Practice Address - Phone:828-231-9125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-21
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes293D00000XLaboratoriesPhysiological Laboratory
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty