Provider Demographics
NPI:1467881433
Name:BUTWIN CHIROPRACTIC
Entity Type:Organization
Organization Name:BUTWIN CHIROPRACTIC
Other - Org Name:BUTWIN CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER, PRESIDENT, VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:317-848-4408
Mailing Address - Street 1:890 E 116TH ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3475
Mailing Address - Country:US
Mailing Address - Phone:317-848-4408
Mailing Address - Fax:317-848-4407
Practice Address - Street 1:890 E 116TH ST
Practice Address - Street 2:SUITE 108
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3475
Practice Address - Country:US
Practice Address - Phone:317-848-4408
Practice Address - Fax:317-848-4407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-11
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002596A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty