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Individual

LORA ROSE BUTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
4717 FAIRWAY POINTE CT, LOUISVILLE, KY 40241-3431
(606) 571-2857
Mailing address
4717 FAIRWAY POINTE CT, LOUISVILLE, KY 40241-3431
(606) 571-2857

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
174806
KY
225X00000X
Occupational Therapist
31006550A
IN
252Y00000X
Early Intervention Provider Agency
Primary
175806
KY

Other

Enumeration date
02/28/2018
Last updated
08/10/2022
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