Provider Demographics
NPI:1174270912
Name:BUTLER, COURTNEY CATHLEEN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:CATHLEEN
Last Name:BUTLER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14538 US HIGHWAY 19 S
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31757-4869
Mailing Address - Country:US
Mailing Address - Phone:229-233-6677
Mailing Address - Fax:229-233-6678
Practice Address - Street 1:14538 US HWY 19 S
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31757
Practice Address - Country:US
Practice Address - Phone:229-233-6677
Practice Address - Fax:229-233-6678
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT015773225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist