Individual
MS. MARY LOU BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 COGBURN CT, COLUMBIA, SC 29229-8075
(803) 771-6351
(843) 868-8052
Mailing address
5 COGBURN CT, COLUMBIA, SC 29229-8075
(803) 771-6351
(843) 868-8052
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
IHCP-0973
SC
Other
Enumeration date
12/30/2018
Last updated
12/30/2018
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