Provider Demographics
NPI:1033264114
Name:BUTCH, BILLY E (PT, MS, ATC)
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:E
Last Name:BUTCH
Suffix:
Gender:M
Credentials:PT, MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-2123
Mailing Address - Country:US
Mailing Address - Phone:412-366-3880
Mailing Address - Fax:412-366-7655
Practice Address - Street 1:1033 PERRY HWY
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2123
Practice Address - Country:US
Practice Address - Phone:412-366-3880
Practice Address - Fax:412-366-7655
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA561758OtherBLUE SHIELD GROUP NUMBER
PA617242OtherBLUE SHIELD PIN NUMBER
PA650014022OtherPA RAILROAD MEDICARE NUMB
PA617242OtherBLUE SHIELD PIN NUMBER