MEDICARE: BUTLER FAMILY CHIROPRACTIC LLC

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

General Provider Information

NPI Number	:	1225626146
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUTLER FAMILY CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	9726 TOUCHTON RD STE 301
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-8307
Country	:	US
Telephone Number	:	904-928-3884
Fax Number	:	904-541-8733

Provider Business Practice Location Address
First Line	:	9726 TOUCHTON RD STE 301
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-8307
Country	:	US
Telephone Number	:	904-928-3884
Fax Number	:	904-541-8733

Authorized Official
Title or Position	:	OWNER
Name	:	RHETT BUTLER
Credential	:
Telephone Number	:	904-928-3884

Provider Enumeration Date	:	01/06/2021
Last Update Date	:	01/06/2021

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