Provider Demographics
NPI:1063953503
Name:BUTTERFIELD, DONALD (DC)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:BUTTERFIELD
Suffix:
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 1:2901 JUAN TABO BLVD SUITE 121B
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112
Mailing Address - Country:US
Mailing Address - Phone:505-697-8062
Mailing Address - Fax:
Practice Address - Street 1:2901 JUAN TABO BLVD NE
Practice Address - Street 2:STE 121B
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-1869
Practice Address - Country:US
Practice Address - Phone:801-695-5720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-16
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2161111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor