Provider Demographics
NPI:1417984634
Name:BUTTERY, THOMAS ANDREW (DPT, ATC, CSCS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ANDREW
Last Name:BUTTERY
Suffix:
Gender:M
Credentials:DPT, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 ROUTE 6 W
Mailing Address - Street 2:
Mailing Address - City:GALETON
Mailing Address - State:PA
Mailing Address - Zip Code:16922-9126
Mailing Address - Country:US
Mailing Address - Phone:814-335-7779
Mailing Address - Fax:
Practice Address - Street 1:1312 ROUTE 6 W
Practice Address - Street 2:
Practice Address - City:GALETON
Practice Address - State:PA
Practice Address - Zip Code:16922-9126
Practice Address - Country:US
Practice Address - Phone:814-335-7779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012997L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist