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General NPI Number Information
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NPI Number | 1083774459
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Entity Type | Organization
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Legal Business Name | WILLIAM E. SCHULTZ, OD LLC
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 10/08/2007
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Provider Practice Location Address
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Address Line | 1971 WENTZVILLE PKWY
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City | WENTZVILLE
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State | MO
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Zip | 63385-3424
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Country | US
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Telephone | 636-639-1855
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Fax | 639-390-3959
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Provider Business Mailing Address
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Address Line | 1971 WENTZVILLE PKWY
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City | WENTZVILLE
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State | MO
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Zip | 63385-3424
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Country | US
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Telephone | 636-639-1855
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Fax | 639-390-3959
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM E SCHULTZ
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Credential | OD
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Telephone | 636-639-1855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T02335
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License Number State | MO
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