Clay Butler

Individual provider Active NPI Athletic Trainer · Barbourville, KY

NPI 1720512403 · NPPES record last updated Apr 19, 2017

Key facts

NPI
1720512403
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
AT637 (KY)
Practice address
310 College St
Barbourville, KY 40906-1410
Phone
(606) 546-1303
NPI assigned
Apr 19, 2017
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
AT637KYMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT637 KY Yes

Addresses

Primary practice location

310 College St
Barbourville, KY 40906-1410

Mailing address

213 High St
Barbourville, KY 40906-1435
Phone (606) 546-1303

Other providers in Barbourville, KY

All providers in Barbourville, KY · Athletic Trainer in Kentucky

Sources for this page

Verify at the official NPI Registry.