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Individual

JEFFREY MICHAEL BUTLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSPT PHYSICAL THERAP

Contact information

Practice address
5070 ION DR STE 210, SPARKS, NV 89436-1612
(775) 786-3040
(775) 348-3054
Mailing address
555 N ARLINGTON AVE, RENO, NV 89503-4723
(775) 786-3040
(775) 786-1887

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1593
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100502523
NV
01
11225081
CAQH
Enumeration date
11/15/2006
Last updated
04/29/2022
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