Provider Demographics
NPI:1407000912
Name:BUTLER, COLLEEN A (AP)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:A
Last Name:BUTLER
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 NE 6TH AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5435
Mailing Address - Country:US
Mailing Address - Phone:561-276-3388
Mailing Address - Fax:561-276-3311
Practice Address - Street 1:75 NE 6TH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5435
Practice Address - Country:US
Practice Address - Phone:561-276-3388
Practice Address - Fax:561-276-3311
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAO2598171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist