Individual
AUSTIN THOMAS BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
201 S 14TH ST, HERRIN, IL 62948-3631
(618) 942-2171
Mailing address
201 S 14TH ST, HERRIN, IL 62948-3631
(618) 942-2171
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096004660
IL
Other
Enumeration date
11/27/2019
Last updated
11/27/2019
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