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General NPI Number Information
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NPI Number | 1720358153
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Entity Type | Individual
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Provider Name | NICHOLE RENE SCHULTZ DC
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Gender | Female
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Dates
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Enumeration Date | 01/02/2012
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Last Update Date | 03/25/2019
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Provider Practice Location Address
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Address Line | 17280 W NORTH AVE STE G102
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City | BROOKFIELD
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State | WI
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Zip | 53045-4367
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Country | US
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Telephone | 262-789-0576
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Fax | 262-789-5357
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Provider Business Mailing Address
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Address Line | 1372N 59TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53208-2140
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Country | US
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Telephone | 309-335-6618
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4740-12
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License Number State | WI
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