Provider Demographics
NPI:1740719335
Name:BUTLER, ASHLYN RAE (DPT)
Entity type:Individual
Prefix:
First Name:ASHLYN
Middle Name:RAE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ASHLYN
Other - Middle Name:RAE
Other - Last Name:BRENNAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2020 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-4007
Mailing Address - Country:US
Mailing Address - Phone:307-333-2873
Mailing Address - Fax:
Practice Address - Street 1:2020 E 12TH ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-4007
Practice Address - Country:US
Practice Address - Phone:307-333-2873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist