MEDICARE: BUTLER-TOWNSEND CHIROPRACTIC CLINIC, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	06284	IA
2	111N00000X	Chiropractor	06338	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	28959	OTHER	IA	WELLMARK BCBS

General Provider Information

NPI Number	:	1346318185
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUTLER-TOWNSEND CHIROPRACTIC CLINIC, P.C.

Provider Business Mailing Address
First Line	:	3104 S LAKEPORT ST
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51106-4222
Country	:	US
Telephone Number	:	712-266-0500
Fax Number	:	712-266-0501

Provider Business Practice Location Address
First Line	:	3104 S LAKEPORT ST
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51106-4222
Country	:	US
Telephone Number	:	712-266-0500
Fax Number	:	712-266-0501

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. CYNTHIA BUTLER
Credential	:	D.C.
Telephone Number	:	712-266-0500

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	08/18/2010

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Directions to “BUTLER-TOWNSEND CHIROPRACTIC CLINIC, P.C. ” Practice Location

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