Individual
MR. KAGE D BUTCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT, ATC, CSCS
Contact information
Practice address
1210 S LAPEER RD, LAKE ORION, MI 48360-1433
(248) 814-8060
(248) 814-8070
Mailing address
1210 S LAPEER RD, LAKE ORION, MI 48360-1433
(248) 814-8060
(248) 814-8070
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501009997
MI
2255A2300X
Athletic Trainer
109402413
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650E61190
BCBS
MI
Enumeration date
07/10/2008
Last updated
01/28/2009
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