Provider Demographics
NPI:1740296011
Name:BUTLER, LESLIE ANNE (MPT, MS, MTC)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ANNE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MPT, MS, MTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:9250 CORKSCREW ROAD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33928-3216
Mailing Address - Country:US
Mailing Address - Phone:239-390-1656
Mailing Address - Fax:239-390-1686
Practice Address - Street 1:9250 CORKSCREW ROAD
Practice Address - Street 2:SUITE 10
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33928-3216
Practice Address - Country:US
Practice Address - Phone:239-390-1656
Practice Address - Fax:239-390-1686
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL22034225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist