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Individual

MARK BUTANIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDMT

Contact information

Practice address
3913 N I 10 SERVICE RD W APT 239, METAIRIE, LA 70002-6828
(717) 659-3239
Mailing address
3913 N I 10 SERVICE RD W APT 239, METAIRIE, LA 70002-6828
(717) 659-3239

Taxonomy

Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary

Other

Enumeration date
04/10/2012
Last updated
04/10/2012
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