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NPI Code Detail

MEDICARE: OLIVIA RAE BUTLER PT, DPT

MEDICARE: OLIVIA RAE BUTLER PT, DPT
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
1225100000XPhysical Therapist17785WI

General Provider Information

NPI Number : 1710819651
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA RAE BUTLER PT, DPT
Provider Business Mailing Address
First Line : 1200 OAKLEAF WAY STE B
Second Line :
City : ALTOONA
State : WI
Zip : 54720-2217
Country : US
Telephone Number : 715-839-9266
Fax Number : 715-839-8761
Provider Business Practice Location Address
First Line : 2919 STOUT RD
Second Line :
City : MENOMONIE
State : WI
Zip : 54751-2313
Country : US
Telephone Number : 715-953-4040
Fax Number : 715-313-7000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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