Provider Demographics
NPI:1063791515
Name:ELMORE CHIROPRACTIC, LLC, CRAIG T. BUTLER, II, DC
Entity type:Organization
Organization Name:ELMORE CHIROPRACTIC, LLC, CRAIG T. BUTLER, II, DC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:440-289-4071
Mailing Address - Street 1:PO BOX 327
Mailing Address - Street 2:
Mailing Address - City:ELMORE
Mailing Address - State:OH
Mailing Address - Zip Code:43416
Mailing Address - Country:US
Mailing Address - Phone:419-862-9014
Mailing Address - Fax:888-977-1978
Practice Address - Street 1:337 RICE ST
Practice Address - Street 2:
Practice Address - City:ELMORE
Practice Address - State:OH
Practice Address - Zip Code:43416
Practice Address - Country:US
Practice Address - Phone:419-862-9014
Practice Address - Fax:888-977-1978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-15
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4165111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty