Organization
OTTER TAIL PODIATRY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARC J BUTCHER D.P.M. (PRESIDENT)
(218) 736-6868
Entity
Organization
Contact information
Practice address
120 E JUNIUS AVE, FERGUS FALLS, MN 56537-2819
(218) 736-6868
(218) 736-6017
Mailing address
120 E JUNIUS AVE, FERGUS FALLS, MN 56537-2819
(218) 736-6868
(218) 736-6017
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
828
MN
213EP1101X
Primary Podiatric Medicine Podiatrist
828
MN
213ER0200X
Radiology Podiatrist
828
MN
213ES0103X
Foot & Ankle Surgery Podiatrist
828
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619065398
NPI
—
Enumeration date
08/09/2011
Last updated
08/09/2011
Update your record
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