Healthcare Provider Details

I. General information

NPI: 1619144755
Provider Name (Legal Business Name): MATTHEW EDWARD SCHULZ D.C., L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2008
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 SOUTH WALKER STREET
BLOOMINGTON IN
47403
US

IV. Provider business mailing address

525 SOUTH WALKER STREET
BLOOMINGTON IN
47403
US

V. Phone/Fax

Practice location:
  • Phone: 812-333-8780
  • Fax: 812-335-1010
Mailing address:
  • Phone: 812-333-8780
  • Fax: 812-335-1010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08002297A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number81000081A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: