Amanda Jeanice Buttress, PT
Individual provider Active NPI Physical Therapist · Miami, OK
NPI 1124232152 · NPPES record last updated Nov 4, 2013
Key facts
- NPI
- 1124232152
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 3817 (OK)
- Practice address
- 1505 E Steve Owens Blvd
Miami, OK 74354-7917 - Phone
- (918) 542-4101
- Fax
- (918) 542-4410
- NPI assigned
- May 9, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3817 | OK | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3817 | OK | Yes |
Addresses
Primary practice location
1505 E Steve Owens Blvd
Miami, OK 74354-7917
Mailing address
PO Box 201
Wyandotte, OK 74370-0201
Phone (918) 688-5182
Other providers in Miami, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.