Provider Demographics
NPI:1497342489
Name:BUTTS, CHANCE ATTILA
Entity Type:Individual
Prefix:
First Name:CHANCE
Middle Name:ATTILA
Last Name:BUTTS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 W MERCER LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-5124
Mailing Address - Country:US
Mailing Address - Phone:505-980-4725
Mailing Address - Fax:
Practice Address - Street 1:924 W MERCER LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-5124
Practice Address - Country:US
Practice Address - Phone:505-980-4725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-24
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty