Provider Demographics
NPI:1528728771
Name:BUTLER-KAUPPILA, MADISON (PT, DPT)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:BUTLER-KAUPPILA
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 1:1 E LEXINGTON AVE UNIT 311
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2479
Mailing Address - Country:US
Mailing Address - Phone:623-261-0929
Mailing Address - Fax:
Practice Address - Street 1:1885 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-2551
Practice Address - Country:US
Practice Address - Phone:623-261-0929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist