Individual
BRANDON JACOB BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
121 ROUND TOP HILL RD SE, MEADVILLE, MS 39653-8140
(601) 384-0288
Mailing address
121 ROUND TOP HILL RD SE, MEADVILLE, MS 39653-8140
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
LPTA4277
MS
Other
Enumeration date
08/27/2007
Last updated
08/27/2007
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