Individual
TERESA DIANE BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1919 LATHROP ST, SUITE 222, FAIRBANKS, AK 99701-5937
(907) 456-5990
Mailing address
1919 LATHROP ST, SUITE 222, FAIRBANKS, AK 99701-5937
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2443
AK
Other
Enumeration date
06/19/2012
Last updated
06/19/2012
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