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General NPI Number Information
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NPI Number | 1629576012
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Entity Type | Organization
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Legal Business Name | SCHULTZ ACUPUNCTURE & THERAPEUTICS, LLC
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Dates
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Enumeration Date | 01/31/2018
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Last Update Date | 01/31/2018
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Provider Practice Location Address
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Address Line | 802 LOIS DR
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City | SUN PRAIRIE
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State | WI
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Zip | 53590-1186
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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 | 9 SPRINGVIEW CT APT D
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City | MADISON
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State | WI
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Zip | 53704-7369
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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 | OWNER/PRACTITIONER
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Name | CORY M SCHULTZ
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Credential | L.AC.
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Telephone | 608-358-7420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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