MEDICARE: MARY-ANN BUTTS L.M.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MT1590	ME

General Provider Information

NPI Number	:	1326299405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY-ANN BUTTS L.M.T.

Provider Business Mailing Address
First Line	:	583 FOREST AVE
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04101-1547
Country	:	US
Telephone Number	:	207-772-9441
Fax Number	:

Provider Business Practice Location Address
First Line	:	583 FOREST AVE
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04101-1547
Country	:	US
Telephone Number	:	207-772-9441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2008
Last Update Date	:	10/07/2008

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Directions to “ MARY-ANN BUTTS L.M.T.” Practice Location

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