Individual
BRYAN BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2635 N 63RD ST, LINCOLN, NE 68507-2422
(402) 429-1799
Mailing address
1521 KINGSTON RD, LINCOLN, NE 68506-1524
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
945
NE
2255A2300X
Athletic Trainer
AT.0001925
CO
Other
Enumeration date
01/11/2017
Last updated
04/26/2019
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