Provider Demographics
NPI:1093370652
Name:BUTCHER, CHELSEA LEIGH
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:LEIGH
Last Name:BUTCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 GREENBRIAR RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-6498
Mailing Address - Country:US
Mailing Address - Phone:256-248-9102
Mailing Address - Fax:
Practice Address - Street 1:418 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:TN
Practice Address - Zip Code:38485-2629
Practice Address - Country:US
Practice Address - Phone:931-722-3644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator