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General NPI Number Information
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NPI Number | 1215940630
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Entity Type | Organization
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Legal Business Name | DOCTOR BUTLER EYECARE, LLC
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 34 S MAIN ST SUITE 5
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City | WILKES BARRE
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State | PA
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Zip | 18701-1723
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Country | US
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Telephone | 570-822-9727
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Fax | 570-822-8743
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Provider Business Mailing Address
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Address Line | 34 S MAIN ST SUITE 5
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City | WILKES BARRE
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State | PA
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Zip | 18701-1723
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Country | US
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Telephone | 570-822-9727
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Fax | 570-822-8743
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Authorized Official
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Title or Position | OWNER
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Name | DR. PATRICIA A BUTLER
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Credential | O.D.
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Telephone | 570-852-1920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG1584
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License Number State | PA
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