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General NPI Number Information
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NPI Number | 1194502013
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Entity Type | Individual
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Provider Name | ANITA BUTLER CPHT
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Gender | Female
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Dates
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Enumeration Date | 09/13/2023
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 15401 N COMMERCE DR
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City | DEARBORN
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State | MI
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Zip | 48120-1208
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Country | US
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Telephone | 248-508-4199
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Fax |
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Provider Business Mailing Address
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Address Line | 15401 N COMMERCE DR
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City | DEARBORN
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State | MI
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Zip | 48120-1208
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Country | US
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Telephone | 248-508-4199
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 5303007152
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License Number State | MI
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