MEDICARE: DR. LOTEM LEAH SCHULKE D.C.

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	111NP0017X	Pediatric Chiropractor	CHIR009629	GA
2	111N00000X	Chiropractor	CHIR009629	GA

General Provider Information

NPI Number	:	1821454448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOTEM LEAH SCHULKE D.C.

Provider Business Mailing Address
First Line	:	2487 CEDARCREST RD STE 713
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-2730
Country	:	US
Telephone Number	:	470-580-4922
Fax Number	:

Provider Business Practice Location Address
First Line	:	2487 CEDARCREST RD STE 713
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-2730
Country	:	US
Telephone Number	:	470-580-4922
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2016
Last Update Date	:	07/03/2024

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