Individual
KENDAL RYAN BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1004 HEALTH CENTER DR STE 100, MATTOON, IL 61938-4607
(217) 238-3435
(217) 238-3492
Mailing address
PO BOX 372, MATTOON, IL 61938-0372
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-008144
IL
Other
Enumeration date
09/30/2019
Last updated
07/11/2024
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