Provider Demographics
NPI:1104227420
Name:BUTKUS, ELIZABETH (PT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BUTKUS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 HUNTINGDON PIKE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6130
Mailing Address - Country:US
Mailing Address - Phone:215-745-4050
Mailing Address - Fax:215-745-9333
Practice Address - Street 1:2301 HUNTINGDON PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-6130
Practice Address - Country:US
Practice Address - Phone:215-745-4050
Practice Address - Fax:215-745-9333
Is Sole Proprietor?:No
Enumeration Date:2014-09-05
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023712225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist