Provider Demographics
NPI:1538044334
Name:AMPERSAND EMPIRE LLC
Entity type:Organization
Organization Name:AMPERSAND EMPIRE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:541-350-2053
Mailing Address - Street 1:1013 LAKE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-5002
Mailing Address - Country:US
Mailing Address - Phone:208-597-7597
Mailing Address - Fax:
Practice Address - Street 1:1013 LAKE ST STE 100
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-5002
Practice Address - Country:US
Practice Address - Phone:208-597-7597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty