MEDICARE: COLLEEN A BUTLER A.P.

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
1	171100000X	Acupuncturist	AO2598	FL

General Provider Information

NPI Number	:	1407000912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLEEN A BUTLER A.P.

Provider Business Mailing Address
First Line	:	75 NE 6TH AVE
Second Line	:	SUITE 202
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-5435
Country	:	US
Telephone Number	:	561-276-3388
Fax Number	:	561-276-3311

Provider Business Practice Location Address
First Line	:	75 NE 6TH AVE
Second Line	:	SUITE 202
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-5435
Country	:	US
Telephone Number	:	561-276-3388
Fax Number	:	561-276-3311

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2008
Last Update Date	:	11/11/2008

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