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General NPI Number Information
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NPI Number | 1942662515
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Entity Type | Organization
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Legal Business Name | MATTHEW C SCHULKE DC LLC
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 75 EXECUTIVE DR STE J
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City | CARMEL
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State | IN
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Zip | 46032-2993
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Country | US
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Telephone | 317-580-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 75 EXECUTIVE DR STE J
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City | CARMEL
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State | IN
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Zip | 46032-2993
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Country | US
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Telephone | 317-580-0000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW C SCHULKE
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Credential | D.C.
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Telephone | 317-502-4164
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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 | 08002709A
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License Number State | IN
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