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General NPI Number Information
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NPI Number | 1104027010
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Entity Type | Organization
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Legal Business Name | SCHULZ CHIROPRACTIC HEALTH & WELLNESS CLINIC PC
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 07/19/2007
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Provider Practice Location Address
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Address Line | 2410 E SHAWNEE RD SUITE C
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City | MUSKOGEE
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State | OK
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Zip | 74403-1508
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Country | US
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Telephone | 918-686-7222
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1105
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City | FORT GIBSON
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State | OK
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Zip | 74434-1105
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Country | US
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Telephone | 918-686-7222
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LACEY MICHELLE SCHULZ
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Credential | D.C.
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Telephone | 918-686-7222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3820
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License Number State | OK
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