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NPI Code Detail

MEDICARE: CAROLYN BUTLER CEBALO P.T.

MEDICARE: CAROLYN BUTLER CEBALO P.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
1225100000XPhysical TherapistPT005122GA

General Provider Information

NPI Number : 1841221579
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN BUTLER CEBALO P.T.
Provider Business Mailing Address
First Line : 3414 WARNER AVE STE 103
Second Line :
City : LOUISVILLE
State : KY
Zip : 40207-3608
Country : US
Telephone Number : 404-323-0131
Fax Number :
Provider Business Practice Location Address
First Line : 3920 DUTCHMANS LN
Second Line : SUITE 303
City : LOUISVILLE
State : KY
Zip : 40207-4702
Country : US
Telephone Number : 502-899-3009
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 06/30/2026

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