| Doctor Name: | MRS. KANDI MONIQUE POTTER |
| NPI Number: | 1720235807 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 2004015912 |
| Business Practice Address: | 201 S Northpark Ln Joplin, MO - 648018426 |
| Business Phone Number: | 4176234313 |
| Business Fax Number: | 4186210129 |
| Mailing Address: | 1308a W 16th St, WEBB CITY |
| State: | MO |
| Postal Code: | 648703200 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/20/2008 |
| NPI Last Update Date: | 08/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2004015912 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |