Provider Demographics
NPI:1841993789
Name:BUTTLE, LEXIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:LEXIE
Middle Name:
Last Name:BUTTLE
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 1:66 TURNER ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2892
Mailing Address - Country:US
Mailing Address - Phone:562-412-9881
Mailing Address - Fax:
Practice Address - Street 1:66 TURNER ST APT 3
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2892
Practice Address - Country:US
Practice Address - Phone:562-412-9881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH5117225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist