Individual
BRENT R BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1055 N 500 W STE 122, PROVO, UT 84604-3305
(801) 429-0610
(801) 429-0629
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
221116572401
UT
Other
Enumeration date
08/21/2006
Last updated
10/18/2018
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