Provider Demographics
NPI:1346318185
Name:BUTLER-TOWNSEND CHIROPRACTIC CLINIC, P.C.
Entity Type:Organization
Organization Name:BUTLER-TOWNSEND CHIROPRACTIC CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-266-0500
Mailing Address - Street 1:3104 S LAKEPORT ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-4222
Mailing Address - Country:US
Mailing Address - Phone:712-266-0500
Mailing Address - Fax:712-266-0501
Practice Address - Street 1:3104 S LAKEPORT ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4222
Practice Address - Country:US
Practice Address - Phone:712-266-0500
Practice Address - Fax:712-266-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06338111N00000X
IA06284111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0415943Medicaid
IA28959OtherWELLMARK BCBS
IA0415943Medicaid