Individual
MARISSA LYNN BUTCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
301 N 8TH ST, SUITE PAV5B, SPRINGFIELD, IL 62701-1041
(217) 545-8000
(217) 545-0253
Mailing address
PO BOX 19662, SPRINGFIELD, IL 62794-9662
(217) 545-8000
(217) 545-0253
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-005258
IL
Other
Enumeration date
10/30/2014
Last updated
10/20/2020
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