Individual
DR. TIMOTHY M BUTCKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2045 ASHER CT, EAST LANSING, MI 48823
(517) 351-9240
Mailing address
2045 ASHER CT, EAST LANSING, MI 48823
(517) 351-9240
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038.011310
IL
111N00000X
Chiropractor
Primary
2301010138
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629625
BLUE CROSS BLUE SHIELD
IL
Enumeration date
01/30/2009
Last updated
06/24/2019
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