Provider Demographics
NPI:1386351054
Name:BUTLER, SYDNEY MARIE ALTMEYER (MOT)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:MARIE ALTMEYER
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:MARIE
Other - Last Name:ALTMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1650 LYNDON FARM CT STE 300
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5005
Mailing Address - Country:US
Mailing Address - Phone:502-882-9379
Mailing Address - Fax:502-805-0526
Practice Address - Street 1:225 CROSSLAKE DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-8198
Practice Address - Country:US
Practice Address - Phone:502-882-9379
Practice Address - Fax:502-805-0526
Is Sole Proprietor?:No
Enumeration Date:2022-11-02
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31007891A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist