Provider Demographics
NPI:1457474058
Name:DIXON-BUTERA, TAMIE LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:TAMIE
Middle Name:LEE
Last Name:DIXON-BUTERA
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 1:1667 SHIRLEY RD
Mailing Address - Street 2:
Mailing Address - City:SUMMIT POINT
Mailing Address - State:WV
Mailing Address - Zip Code:25446-3673
Mailing Address - Country:US
Mailing Address - Phone:304-725-2094
Mailing Address - Fax:
Practice Address - Street 1:1667 SHIRLEY RD
Practice Address - Street 2:
Practice Address - City:SUMMIT POINT
Practice Address - State:WV
Practice Address - Zip Code:25446-3673
Practice Address - Country:US
Practice Address - Phone:304-725-2094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV609111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor