| John J. Potente P.c. | |
|
3181 Prairie St Sw Suite 105 Grandville MI 49418-2097 | |
| (616) 249-1800 | |
| Not Available |
| Full Name | John J. Potente P.c. |
|---|---|
| Speciality | Clinic/center |
| Location | 3181 Prairie St Sw, Grandville, Michigan |
| Authorized Official Name and Position | John Joseph Potente (PRESIDENT) |
| Authorized Official Contact | 6162491800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John J. Potente P.c. 3181 Prairie St Sw Suite 105 Grandville MI 49418-2097 Ph: (616) 249-1800 | John J. Potente P.c. 3181 Prairie St Sw Suite 105 Grandville MI 49418-2097 Ph: (616) 249-1800 |
| NPI Number | 1639334626 |
|---|---|
| Provider Enumeration Date | 07/19/2008 |
| Last Update Date | 07/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639334626 | NPI | - | NPPES |
| 950D152200 | Other | MI | BLUE CROSS& BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2301004828 (Michigan) | Primary |
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