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General NPI Number Information
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NPI Number | 1992902886
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Entity Type | Individual
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Provider Name | JASON BUTCHER OTR
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Gender | Male
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 235 W AIRPORT BLVD
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City | PENSACOLA
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State | FL
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Zip | 32505-2239
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Country | US
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Telephone | 850-857-5200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 164
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City | OIL SPRINGS
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State | KY
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Zip | 41238-0164
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Country | US
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Telephone | 606-205-1662
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT11487
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License Number State | FL
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