MEDICARE: DR. CYNTHIA J BUTLER D.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

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

General Provider Information

NPI Number	:	1831196724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA J BUTLER D.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 STREET
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51106-4222
Country	:	US
Telephone Number	:	712-266-0500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	11/03/2010

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