Healthcare Provider Details

I. General information

NPI: 1629178231
Provider Name (Legal Business Name): WILLIAM CHRISTOPHER SCHULTE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2006
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 13TH AVE NE SUITE 104-C
MINNEAPOLIS MN
55413-1002
US

IV. Provider business mailing address

34 13TH AVE NE SUITE 104-C
MINNEAPOLIS MN
55413-1002
US

V. Phone/Fax

Practice location:
  • Phone: 612-886-2889
  • Fax:
Mailing address:
  • Phone: 612-886-2889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number3985
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: