| Doctor Name: | MR. BRYAN S POTTER |
| NPI Number: | 1205959558 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 2166 |
| Business Practice Address: | 600 Oregon St Hiawatha, KS - 664342231 |
| Business Phone Number: | 7857422464 |
| Business Fax Number: | 7857422552 |
| Mailing Address: | 307 S 6th St, HIAWATHA |
| State: | KS |
| Postal Code: | 664342511 |
| Phone Number: | 7857423559 |
| Fax Number: | |
| NPI Enumeration Date: | 04/09/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2166 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |