Individual
TONIQUE BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12174 MCKELVEY PL, BRIDGETON, MO 63044-2569
(314) 877-9387
Mailing address
12174 MCKELVEY PL, BRIDGETON, MO 63044-2569
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/22/2018
Last updated
01/22/2018
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