Provider Demographics
NPI:1194099747
Name:BUTLER CHIROPRACTIC REHAB CENTER, INC
Entity type:Organization
Organization Name:BUTLER CHIROPRACTIC REHAB CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:CHIROPRACTOR
Authorized Official - Phone:404-303-7887
Mailing Address - Street 1:290 CARPENTER DR NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4929
Mailing Address - Country:US
Mailing Address - Phone:404-303-7887
Mailing Address - Fax:404-303-7887
Practice Address - Street 1:290 CARPENTER DR NE
Practice Address - Street 2:SUITE 100
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4929
Practice Address - Country:US
Practice Address - Phone:404-303-7887
Practice Address - Fax:404-303-7887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007646111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty