MEDICARE: DREW BUTLER 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
1	225200000X	Physical Therapy Assistant	4027	OK

General Provider Information

NPI Number	:	1972439289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DREW BUTLER PTA

Provider Business Mailing Address
First Line	:	4900 ROGERS AVE STE 100F
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-2068
Country	:	US
Telephone Number	:	479-242-9771
Fax Number	:	479-242-9774

Provider Business Practice Location Address
First Line	:	4900 ROGERS AVE STE 100F
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-2068
Country	:	US
Telephone Number	:	479-242-9771
Fax Number	:	479-242-9774

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

Provider Enumeration Date	:	06/23/2026
Last Update Date	:	06/23/2026

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Directions to “ DREW BUTLER PTA” Practice Location

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