Individual
RICHARD BRIAN BUTORAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
1711 DOOLITTLE AVE, FORT WORTH, TX 76179
(904) 588-2906
Mailing address
5113 BAYRIDGE CT, FORT WORTH, TX 76179-4255
(904) 588-2906
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/23/2006
Last updated
07/08/2007
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