Most Relevant Information
Provider Data
| NPI Number: | 1003429150 |
| Provider Name: | MACKENNA BUTLER PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 7475 |
Most Important Dates
| Enumeration Date: | 08/28/2020 |
| Last Updated: | 08/28/2020 |
Provider Practice Location
2036 US HIGHWAY 45 BYP S
TRENTON
TN
383822941
Practice Location Phone/Fax
| Phone: | 7318554500 |
| Fax: |
Provider Mailing Location
138 HERD LAW RD
TRENTON
TN
383829239
Provider Mailing Phone/Fax
| Phone: | 7316182114 |
| Fax: |