| Doctor Name: | MRS. LORI LYNN POTTER |
| NPI Number: | 1053743435 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARDMS |
| License Number: | |
| Business Practice Address: | 7769 Woodland Rd Lake Odessa, MI - 488499323 |
| Business Phone Number: | 2698385865 |
| Business Fax Number: | |
| Mailing Address: | 7769 Woodland Rd, LAKE ODESSA |
| State: | MI |
| Postal Code: | 488499323 |
| Phone Number: | 2698385865 |
| Fax Number: | |
| NPI Enumeration Date: | 08/07/2013 |
| NPI Last Update Date: | 08/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471S1302X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Sonography |
| Taxonomy Definition: | |