Provider Demographics
NPI:1972116069
Name:BUTTERFIELD, LUCAS SCOTT (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:LUCAS
Middle Name:SCOTT
Last Name:BUTTERFIELD
Suffix:
Gender:M
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 1:442 E WOODSTOCK RD STE 3A
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:VT
Mailing Address - Zip Code:05091-3696
Mailing Address - Country:US
Mailing Address - Phone:802-457-3215
Mailing Address - Fax:802-457-6118
Practice Address - Street 1:442 E WOODSTOCK RD STE 3A
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VT
Practice Address - Zip Code:05091-3696
Practice Address - Country:US
Practice Address - Phone:802-457-3215
Practice Address - Fax:802-457-6118
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0134196225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist