Individual
KEN W BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7707 S MEMORIAL DR, TULSA, OK 74133-3643
(918) 249-1162
Mailing address
2912 N 13TH ST, BROKEN ARROW, OK 74012-9288
(918) 638-8537
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 1590
OK
Other
Enumeration date
05/16/2007
Last updated
07/08/2007
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