Healthcare Provider Details

I. General information

NPI: 1952733768
Provider Name (Legal Business Name): JANA L. BUTLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2013
Last Update Date: 11/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 AMHERST AVE
BUTTE MT
59701-4653
US

IV. Provider business mailing address

1432 ELK LN
BOZEMAN MT
59718-9082
US

V. Phone/Fax

Practice location:
  • Phone: 406-494-7035
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number484
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: