Provider Demographics
NPI:1194179648
Name:BUTCHER, ASHLEY (CFTS)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BUTCHER
Suffix:
Gender:F
Credentials:CFTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 S PIKE ST
Mailing Address - Street 2:
Mailing Address - City:SHINNSTON
Mailing Address - State:WV
Mailing Address - Zip Code:26431-1125
Mailing Address - Country:US
Mailing Address - Phone:304-592-1870
Mailing Address - Fax:304-371-3502
Practice Address - Street 1:409 S PIKE ST
Practice Address - Street 2:
Practice Address - City:SHINNSTON
Practice Address - State:WV
Practice Address - Zip Code:26431-1125
Practice Address - Country:US
Practice Address - Phone:304-592-1870
Practice Address - Fax:304-371-3502
Is Sole Proprietor?:No
Enumeration Date:2016-04-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVCFTS1828224L00000X, 225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter