Individual provider · Type 1 NPI
Jesse Van Butler, PA-C
Surgical Physician Assistant · Decorah, IA
NPI number
1376557769
Active
Practice location
901 Montgomery St
Decorah, IA 52101-2325
Fax (563) 387-1512
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | 10116 (MN) |
Surgical Physician Assistant: Definition to come...
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About NPI 1376557769
Jesse Van Butler, PA-C's National Provider Identifier is 1376557769, issued on Jul 28, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Decorah, IA. The record was last updated on Mar 8, 2011.