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General NPI Number Information
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NPI Number | 1972776961
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Entity Type | Individual
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Provider Name | MYRON JAMAL BUTTS D.C., LA.C
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Gender | Male
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 03/05/2009
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Provider Practice Location Address
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Address Line | 250 W 1ST ST SUITE#148
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City | CLAREMONT
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State | CA
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Zip | 91711-4736
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Country | US
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Telephone | 562-587-2065
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Fax | 909-622-9051
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Provider Business Mailing Address
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Address Line | 1102 TONOPAH AVE.
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City | LA PUENTE
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State | CA
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Zip | 91744
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Country | US
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Telephone | 562-587-2065
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Fax | 909-622-9051
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC30680
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC 12860
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License Number State | CA
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