Healthcare Provider Details

I. General information

NPI: 1033556287
Provider Name (Legal Business Name): ALICIA BUTTERFIELD PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2013
Last Update Date: 05/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 N DARR AVE
GRAND ISLAND NE
68803-4635
US

IV. Provider business mailing address

610 N DARR AVE
GRAND ISLAND NE
68803-4635
US

V. Phone/Fax

Practice location:
  • Phone: 308-382-2635
  • Fax: 308-382-0418
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3130
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: