Provider Demographics
NPI:1376262998
Name:BUTTS, ABBIE R (OTRL)
Entity Type:Individual
Prefix:MS
First Name:ABBIE
Middle Name:R
Last Name:BUTTS
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:965 PARADISE LAKE DR SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-3828
Mailing Address - Country:US
Mailing Address - Phone:616-570-4999
Mailing Address - Fax:
Practice Address - Street 1:145 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MI
Practice Address - Zip Code:49348-1701
Practice Address - Country:US
Practice Address - Phone:269-792-2353
Practice Address - Fax:269-792-2847
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5201013057225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist