Provider Demographics
NPI:1730909847
Name:BUTLER, COURTNEY MADISON
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MADISON
Last Name:BUTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 DRY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37166-2304
Mailing Address - Country:US
Mailing Address - Phone:931-434-4542
Mailing Address - Fax:
Practice Address - Street 1:661 PRESIDENT PL STE 639
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-5671
Practice Address - Country:US
Practice Address - Phone:615-323-5734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3862111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor