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Individual
MR. KAGE D BUTCHER
Active
Individual
MR. KAGE D BUTCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT, ATC, CSCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501009997
MI
2255A2300X
Athletic Trainer
109402413
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650E61190
BCBS
MI
Enumeration date
07/10/2008
Last updated
01/28/2009
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