Individual
MR. CHARLES CHRISTOPHER BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1728 PRENDERGAST LN, SAINT LOUIS, MO 63138-1725
(314) 438-9954
Mailing address
1728 PRENDERGAST LN, SAINT LOUIS, MO 63138-1725
(314) 438-9954
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
043484
MO
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
043484
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043484
PHARMACIST LICENSE
MO
Enumeration date
09/11/2012
Last updated
02/05/2013
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