Individual
RAYMOND T BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2769 KILGORE RD, BUFORD, GA 30519-4444
(678) 482-9313
Mailing address
2769 KILGORE RD, BUFORD, GA 30519-4444
(678) 482-9313
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000000
PERSONAL CARE HOME
GA
Enumeration date
06/22/2021
Last updated
06/22/2021
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