Provider Demographics
NPI:1346361706
Name:BUTLER, KATHLEEN GAIL (DC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:GAIL
Last Name:BUTLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2543 CRAWFORDVILLE HWY.
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CRAWFORDVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32327-2167
Mailing Address - Country:US
Mailing Address - Phone:850-926-8778
Mailing Address - Fax:
Practice Address - Street 1:2543 CRAWFORDVILLE HWY.
Practice Address - Street 2:SUITE 4
Practice Address - City:CRAWFORDVILLE
Practice Address - State:FL
Practice Address - Zip Code:32327-2167
Practice Address - Country:US
Practice Address - Phone:850-926-8778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 7028111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor