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General NPI Number Information
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NPI Number | 1144033911
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Entity Type | Individual
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Provider Name | BREANNA BUTCHER
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Gender | Female
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 255 SUNBRIDGE DR
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City | SALEM
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State | WV
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Zip | 26426-8400
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Country | US
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Telephone | 304-782-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 101 E STATE ST
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City | KENNETT SQUARE
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State | PA
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Zip | 19348-3109
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP042114T
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P23773
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP043886T
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License Number State | WV
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