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Ryan Potter, MT128655

Massage Therapist in San Antonio, TX. Individual provider (NPI-1).

NPI number1982209698
StatusActive
Last updated in NPPESDec 1, 2020

Details

NPI
1982209698
Entity type
Individual (NPI-1)
Name
Ryan Potter
Credential
MT128655
Sex
Male
Sole proprietor
Yes
Enumeration date
Dec 1, 2020
Certification date
Nov 30, 2020
Last updated
Dec 1, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225700000X Massage TherapistMT128655TXYes

Practice location

5100 Nw Loop 410 Apt 4005
San Antonio, TX 78229-5325

Phone 281-943-4620

Mailing address

5100 Nw Loop 410 Apt 4005
San Antonio, TX 78229-5325

Phone 281-943-4620

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