Provider Demographics
NPI:1689992034
Name:BUTLER, BRETT ALLEN (DC)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:ALLEN
Last Name:BUTLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 S LONGMORE
Mailing Address - Street 2:SUITE #8
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-9607
Mailing Address - Country:US
Mailing Address - Phone:480-649-5297
Mailing Address - Fax:480-649-1790
Practice Address - Street 1:1303 S LONGMORE
Practice Address - Street 2:SUITE #8
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-9607
Practice Address - Country:US
Practice Address - Phone:480-649-5297
Practice Address - Fax:480-649-1790
Is Sole Proprietor?:No
Enumeration Date:2010-05-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8125111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor