NPI 1508019639

Gary Potvin

Practitioner Home Modifications Contractor Big Lake, MN

Practice location

Address: 5619 Loon Dr, Big Lake, MN 55309-8984
Phone: (612) 598-6626

Registered specialties

Home Modifications Contractor Primary

Other Service Providers Taxonomy 171WH0202X

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Registry record

NPI: 1508019639
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Nov 2008
Record last updated: 3 Nov 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.