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NPI Code Detail

MEDICARE: CARLA BUTENHOFF OTR/L CHT

MEDICARE: CARLA BUTENHOFF OTR/L CHT
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
1225XH1200XHand Occupational Therapist102131MN

General Provider Information

NPI Number : 1568552578
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLA BUTENHOFF OTR/L CHT
Provider Business Mailing Address
First Line : 1555 NORTHWAY DR
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56303-4555
Country : US
Telephone Number : 320-259-4100
Fax Number : 320-259-8044
Provider Business Practice Location Address
First Line : 1555 NORTHWAY DR
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56303-4555
Country : US
Telephone Number : 320-259-4100
Fax Number : 320-259-8044
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2006
Last Update Date : 11/03/2008

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Directions to “ CARLA BUTENHOFF OTR/L CHT” Practice Location

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