1316112626

Everything you always wanted to know about BUTTIKOFER JOHN DOUGLAS M.A. but were afraid to ask.

BUTTIKOFER JOHN DOUGLAS M.A.

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Provider Last Name Provider Middle Name Provider First Name Provider Credential
BUTTIKOFER JOHN DOUGLAS M.A.
Gender:
Male
Enumeration date:
2008-04-28
Last update date:
2008-04-28
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state

Taxonomies

Taxonomy State License Number Primary?
101YM0800X Mental Health IA 0415 Y

Phone Numbers

Type Number
Mailing Address Telephone Number 6419190647
Practice Location Address Telephone Number 6419190647

Addresses

Type Address City State Postal Country
Mailing Address 607 W BROADWAY AVE SUITE 111 UNIT 41 FAIRFIELD IA 52556 IA
Practice Location Address 607 W BROADWAY AVE SUITE 111 UNIT 41 FAIRFIELD IA 52556 IA