Healthcare Provider Details

I. General information

NPI: 1447382247
Provider Name (Legal Business Name): BUTLER REHAB, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 WHISTLE LN
GILBERTSVILLE KY
42044-8708
US

IV. Provider business mailing address

72 WHISTLE LN
GILBERTSVILLE KY
42044-8708
US

V. Phone/Fax

Practice location:
  • Phone: 270-362-4734
  • Fax: 270-362-4734
Mailing address:
  • Phone: 270-362-4734
  • Fax: 270-362-4734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number001623
License Number StateKY

VIII. Authorized Official

Name: THRESA BUTLER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 270-559-6439