Provider Demographics
NPI:1487836839
Name:BUTTS, GREGORY DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:DAVID
Last Name:BUTTS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 LEGENDS DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-5308
Mailing Address - Country:US
Mailing Address - Phone:615-453-8999
Mailing Address - Fax:615-453-8909
Practice Address - Street 1:155 LEGENDS DR
Practice Address - Street 2:SUITE F
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-5308
Practice Address - Country:US
Practice Address - Phone:615-453-8999
Practice Address - Fax:615-453-8909
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2206111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor