Individual
SHANTE MARIE BUTTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1921 STONECIPHER DR, ADA, OK 74820-3439
(580) 436-3980
Mailing address
18161 COUNTY ROAD 1545, ADA, OK 74820-5303
(405) 926-7299
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5114
OK
Other
Enumeration date
10/27/2023
Last updated
07/12/2024
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