Provider Demographics
NPI:1619606639
Name:BUTTREY, SANDRA (LMT)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:BUTTREY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 HERITAGE PARK DR STE 104
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-1551
Mailing Address - Country:US
Mailing Address - Phone:615-473-7307
Mailing Address - Fax:
Practice Address - Street 1:242 HERITAGE PARK DR STE 104
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1551
Practice Address - Country:US
Practice Address - Phone:615-473-7307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000002232225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist