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General NPI Number Information
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NPI Number | 1114987914
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Entity Type | Individual
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Provider Name | TERRY LEE SCHULTZ OD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 01/04/2012
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Provider Practice Location Address
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Address Line | 210 SHARON RD SUITE B
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City | CIRCLEVILLE
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State | OH
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Zip | 43113-0463
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Country | US
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Telephone | 800-948-3937
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Fax | 740-477-8349
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Provider Business Mailing Address
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Address Line | 50 N PLAZA BLVD
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-1757
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Country | US
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Telephone | 866-587-8790
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Fax | 740-477-8349
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4231T1189
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License Number State | OH
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