# BONNIE ROSS BUTLER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1255332938
- **Gender:** F
- **Credential:** PT,OCS,CSCS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 377196-2401 | UT | Yes |

## Other

- **Enumeration date:** 08/03/2005
- **Last updated:** 12/01/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 52947112802001 | BLUE CROSS BLUE SHIELD | UT |
| 01 | — | 5417 | DMBA | UT |
| 01 | — | 6400593 | UNITED HEALTHCARE | UT |
| 01 | — | 69157 | PEHP | UT |
| 01 | — | CJ9402 | RAILROAD MEDICARE | UT |
| 01 | — | QM0000061055 | ALTIUS | UT |