Individual
THOMAS JACOB BUTENHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPAS, PA-C
Contact information
Practice address
14000 FAIRVIEW DR, BURNSVILLE, MN 55337-5713
(952) 993-8700
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14787
MN
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
14787
MN
Other
Enumeration date
04/16/2024
Last updated
02/19/2025
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