Individual
MR. KENNETH MICHAEL BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SAC-IT, NREMT
Contact information
Practice address
1681 N PROSPECT AVE, MILWAUKEE, WI 53202-6720
(414) 273-8484
Mailing address
1681 N PROSPECT AVE, MILWAUKEE, WI 53202-6720
(414) 273-8484
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19378-130
WI
146N00000X
Basic Emergency Medical Technician
R1032909
WI
Other
Enumeration date
11/12/2021
Last updated
11/12/2021
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