Individual
MR. KENDALL BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2001 S 5TH ST APT 604, WACO, TX 76706-2562
(480) 375-0435
Mailing address
2001 S 5TH ST APT 604, WACO, TX 76706-2562
(480) 375-0435
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/29/2020
Last updated
04/29/2020
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