Provider Demographics
NPI:1558654830
Name:BUTLER, CRAIG THOMAS JR (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:THOMAS
Last Name:BUTLER
Suffix:JR
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:PO BOX 327
Mailing Address - Street 2:
Mailing Address - City:ELMORE
Mailing Address - State:OH
Mailing Address - Zip Code:43416-0327
Mailing Address - Country:US
Mailing Address - Phone:419-862-9014
Mailing Address - Fax:888-977-1978
Practice Address - Street 1:302 RICE ST
Practice Address - Street 2:
Practice Address - City:ELMORE
Practice Address - State:OH
Practice Address - Zip Code:43416-9564
Practice Address - Country:US
Practice Address - Phone:440-289-4071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4165111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor