Individual
NICOLE BUTKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
465 WOLCOTT RD, ADVANCED PHYSICAL THERAPY, WOLCOTT, CT 06716-2613
(203) 879-0107
Mailing address
345 BUCKLAND HILLS DR APT 11132, MANCHESTER, CT 06042-8736
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8074
LICENSE#
CT
Enumeration date
05/10/2007
Last updated
12/14/2016
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