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NPI Code Detail

MEDICARE: CARLA BUTTS PTA

MEDICARE: CARLA BUTTS PTA
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
1225200000XPhysical Therapy Assistant5295TN

General Provider Information

NPI Number : 1568805273
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLA BUTTS PTA
Provider Business Mailing Address
First Line : 103 THOMAS ST
Second Line :
City : DRESDEN
State : TN
Zip : 38225-2365
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1630 E REELFOOT AVE
Second Line :
City : UNION CITY
State : TN
Zip : 38261-6021
Country : US
Telephone Number : 731-885-8095
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2013
Last Update Date : 04/11/2013

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Directions to “ CARLA BUTTS PTA” Practice Location

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