Individual
BETHANY E BUTLER PRATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
1061 HARMON AVE SUITE 1D03, CDR USA MEDDAC CREDENTIALS OFFICE, FORT STEWART, GA 31314-5674
(912) 435-6633
Mailing address
1061 HARMON AVE SUITE 1D03, CDR USA MEDDAC CREDENTIALS OFFICE, FORT STEWART, GA 31314-5674
(912) 435-6633
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AP1518
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047949
ANTHEM
ME
05
—
431784799
—
ME
Enumeration date
10/21/2005
Last updated
09/29/2020
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