Potvin, Elizabeth A

Potvin, Elizabeth A is an individual health care provider with primary practice located at 2450 Ne Mary Rose Pl Suite 110, Bend OR 97701-7132. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Potvin, Elizabeth A can be contacted via phone (541) 318-8388.

Contact Information

Primary practice address
2450 Ne Mary Rose Pl Suite 110 Bend OR 97701-7132
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901004355 Michigan
Eye and Vision Services Providers / Optometrist 152W00000X 3479AT Oregon

Profile Details

NPI number 1063568152
LBN Legal business name Potvin, Elizabeth A
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2007
Last updated Aug 15th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063568152 NPPES
Michigan MEDICAID 944923648

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