Provider Demographics
NPI:1093490369
Name:MCCAULEY, SAVANNAH BUTTS (DC)
Entity Type:Individual
Prefix:DR
First Name:SAVANNAH
Middle Name:BUTTS
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:SAVANNAH
Other - Middle Name:MIZE
Other - Last Name:BUTTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2345 SANDIFER BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:SC
Mailing Address - Zip Code:29693-3945
Mailing Address - Country:US
Mailing Address - Phone:864-973-7242
Mailing Address - Fax:
Practice Address - Street 1:2345 SANDIFER BLVD STE D
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:SC
Practice Address - Zip Code:29693-3945
Practice Address - Country:US
Practice Address - Phone:864-973-7242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-15
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4797111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor