Provider Demographics
NPI:1386721033
Name:BUTTARI, JOHN J (MS PT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:J
Last Name:BUTTARI
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Gender:M
Credentials:MS PT
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Mailing Address - Street 1:PO BOX 147
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113
Mailing Address - Country:US
Mailing Address - Phone:804-378-5010
Mailing Address - Fax:804-378-3264
Practice Address - Street 1:2000 BREMO ROAD
Practice Address - Street 2:SUITE 202
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226
Practice Address - Country:US
Practice Address - Phone:804-285-0148
Practice Address - Fax:804-673-6026
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-08-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA2305203211225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA174357OtherANTHEM