Individual
BRADLEY BUTCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1585 3RD ST BLDG 285, FORT POLK, LA 71459-5102
(726) 780-2175
Mailing address
347 WATSON RD APT 11, LEESVILLE, LA 71446-3076
(337) 208-2097
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
04/21/2026
Last updated
04/21/2026
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