Provider Demographics
NPI:1881360238
Name:BUTLER, KERRIGAN TAYLOR (DPT)
Entity type:Individual
Prefix:DR
First Name:KERRIGAN
Middle Name:TAYLOR
Last Name:BUTLER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 E LANCASTER AVE APT 126
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3464
Mailing Address - Country:US
Mailing Address - Phone:315-591-6781
Mailing Address - Fax:610-642-7017
Practice Address - Street 1:233 E LANCASTER AVE STE 100
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2321
Practice Address - Country:US
Practice Address - Phone:610-642-4494
Practice Address - Fax:610-642-7017
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT029625225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist