Provider Demographics
NPI:1871199463
Name:BUTLER, KELSEY (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11181 EVERBLADES PKWY APT 209
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-9560
Mailing Address - Country:US
Mailing Address - Phone:813-476-5718
Mailing Address - Fax:
Practice Address - Street 1:8300 COLLIER BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-3549
Practice Address - Country:US
Practice Address - Phone:239-354-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT36201225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist