Provider Demographics
NPI:1790967107
Name:BUTTERFILED, RAYMOND JOHN (PT)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:JOHN
Last Name:BUTTERFILED
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 CLARION RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:JOHNSONBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15845-1656
Mailing Address - Country:US
Mailing Address - Phone:814-965-5810
Mailing Address - Fax:814-965-2200
Practice Address - Street 1:81 CLARION RD
Practice Address - Street 2:SUITE 6
Practice Address - City:JOHNSONBURG
Practice Address - State:PA
Practice Address - Zip Code:15845-1656
Practice Address - Country:US
Practice Address - Phone:814-965-5810
Practice Address - Fax:814-965-2200
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT000454E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016409800002Medicaid
PA0016409800002Medicaid