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Individual
TARRY ADAIR BUTNER
Active
Individual
TARRY ADAIR BUTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15636
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0158028000
—
WV
01
—
11937
PRIORITY PARTNERS
MD
01
—
15636
LICENSE #
MD
01
—
258607
ALLIANCE/MD.IPA/OPTIMUM C
MD
01
—
60405501
CAREFIRST BCBS
MD
01
—
E273 0003
GHMSI & BCBS FEERAL
MD
01
—
IWIF 25-99
INJURED WORKERS'
MD
Enumeration date
11/01/2006
Last updated
03/20/2008
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