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General NPI Number Information
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NPI Number | 1235637752
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Entity Type | Individual
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Provider Name | CORY SCHULTZ L.AC
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Gender | Male
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Dates
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Enumeration Date | 01/30/2018
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 1104 21ST STREET
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City | REEDSBURG
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State | WI
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Zip | 53959
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Country | US
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Telephone | 608-358-7420
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Fax |
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Provider Business Mailing Address
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Address Line | S4869B DUNSE RD
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City | REEDSBURG
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State | WI
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Zip | 53959-9548
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Country | US
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Telephone | 608-358-7420
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Fax |
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 965-55
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License Number State | WI
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