Provider Demographics
NPI:1881897312
Name:BUTLER, WENDY DILLARD (DC)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:DILLARD
Last Name:BUTLER
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 1:2734 LEDO RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-7626
Mailing Address - Country:US
Mailing Address - Phone:229-438-7000
Mailing Address - Fax:229-438-7200
Practice Address - Street 1:2734 LEDO RD
Practice Address - Street 2:SUITE 8
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-7626
Practice Address - Country:US
Practice Address - Phone:229-438-7000
Practice Address - Fax:229-438-7200
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6583111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor