Individual
GREGORY D BUTTOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
946
WI
363AM0700X
Medical Physician Assistant
001789
IA
363AM0700X
Medical Physician Assistant
Primary
946
WI
Other
Enumeration date
11/07/2005
Last updated
02/09/2009
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