=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487724951
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALAN J. SCHULTZ D,C.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2006
-----------------------------------------------------
Last Update Date | 11/24/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5850 NW 62 AVE
-----------------------------------------------------
City | JOHNSTON
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50131-0708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-270-2924
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5850 NW 62ND AVE BOX 708
-----------------------------------------------------
City | JOHNSTON
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50131-1537
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-270-2924
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | A5344
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------