Provider Demographics
NPI:1568877157
Name:JASON BUTTLEMAN DC PLLC
Entity Type:Organization
Organization Name:JASON BUTTLEMAN DC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:STEWART
Authorized Official - Last Name:BUTTLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:231-947-0755
Mailing Address - Street 1:10975 E BREWERY CREEK LN
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-6225
Mailing Address - Country:US
Mailing Address - Phone:231-947-0755
Mailing Address - Fax:231-947-1134
Practice Address - Street 1:10975 E BREWERY CREEK LN
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-6225
Practice Address - Country:US
Practice Address - Phone:231-947-0755
Practice Address - Fax:231-947-1134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009099111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty