Individual
DEREK J BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
1514 ELIZABETH AVE, MARINETTE, WI 54143-3220
(715) 735-9433
Mailing address
1514 ELIZABETH AVE, MARINETTE, WI 54143-3220
(715) 735-9433
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2255A2300X
WI
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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