Healthcare Provider Details

I. General information

NPI: 1285158873
Provider Name (Legal Business Name): FYZIOGYM BUTLER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2017
Last Update Date: 07/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

542 EVANS CITY RD
BUTLER PA
16001-8608
US

IV. Provider business mailing address

402 BOW CT
SEVEN FIELDS PA
16046-4355
US

V. Phone/Fax

Practice location:
  • Phone: 724-809-1551
  • Fax: 724-799-8831
Mailing address:
  • Phone: 724-809-1551
  • Fax: 724-799-8831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StatePA

VIII. Authorized Official

Name: MS. JANANN MARIE TURNER
Title or Position: PHYSICAL THERAPIST
Credential: PT
Phone: 724-809-1551