Provider Demographics
NPI:1063522100
Name:BUTLER, ROBERT TIMOTHY II (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:TIMOTHY
Last Name:BUTLER
Suffix:II
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 1:1357 W SHAW AVE
Mailing Address - Street 2:103
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3602
Mailing Address - Country:US
Mailing Address - Phone:559-226-5057
Mailing Address - Fax:559-224-1251
Practice Address - Street 1:1357 W SHAW AVE
Practice Address - Street 2:103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3602
Practice Address - Country:US
Practice Address - Phone:559-226-5057
Practice Address - Fax:559-224-1251
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0011280111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor