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NPI Code Detail

MEDICARE: AISHA BUTLER

MEDICARE: AISHA BUTLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1134433345
Entity Type Code : Individual
Provider Name (Legal Business Name) : AISHA BUTLER
Provider Business Mailing Address
First Line : 6512 AMANDA MICHELLE LN
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89086-1341
Country : US
Telephone Number : 702-581-0873
Fax Number : 702-974-1348
Provider Business Practice Location Address
First Line : 2475 W CHEYENNE AVE STE 130
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-4329
Country : US
Telephone Number : 702-581-0873
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2010
Last Update Date : 07/29/2010

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Directions to “ AISHA BUTLER ” Practice Location

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