Richard Brian Butorac IDC

NPI 1669427290 - Military Health Care Provider - 1710I1002X

NPI Details
NPI 1669427290
Gender Male
Enumeration Date 05/23/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
1711 DOOLITTLE AVE
FORT WORTH TX, 76179, US
Phone (904) 588-2906
Fax
Business Location
5113 BAYRIDGE CT
FORT WORTH TX, 76179-4255, US
Phone (904) 588-2906
Fax
Toxanomy
Taxonomy Code 1710I1002X
License State
License Number
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According to our database, Richard Brian Butorac IDC NPI is 1669427290, taxonomy code is 1710I1002X Richard Brian Butorac IDC physically located at 1711 Doolittle Ave, Fort Worth TX, 76179. NPI Number Richard Brian Butorac IDC has the Individual type.

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1669427290 NPI number is provided on an as is basis without warranty of any kind. 1669427290 is maintained by the National Plan & Provider Enumeration System. The contents of Richard Brian Butorac IDC are for informational purposes only.