Individual
MR. JAMIE LEE BUTIKOFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
171 RAIDER CIR, MOUNT AIRY, GA 30563-3065
(706) 778-7161
(706) 776-3020
Mailing address
PO BOX 743, DEMOREST, GA 30535
(706) 778-7161
(706) 776-3020
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT000323
GA
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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