Healthcare Provider Details

I. General information

NPI: 1790044766
Provider Name (Legal Business Name): KENNETH RAYMOND SCHULTES DVM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2012
Last Update Date: 05/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 FRONT AVE POCAHANTAS VETERINARY CLINIC
POCAHONTAS IA
50574
US

IV. Provider business mailing address

218 FRONT AVE POCAHANTAS VETERINARY CLINIC
POCAHONTAS IA
50574
US

V. Phone/Fax

Practice location:
  • Phone: 712-335-4411
  • Fax: 712-335-4325
Mailing address:
  • Phone: 712-335-4411
  • Fax: 712-335-4325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License NumberIOWA5237
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: