MEDICARE: DR. ROGER WILLIAM SCHELTENS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4253	AZ

General Provider Information

NPI Number	:	1114966934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROGER WILLIAM SCHELTENS D.C.

Provider Business Mailing Address
First Line	:	1325 W SAINT MARYS RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-3112
Country	:	US
Telephone Number	:	520-624-8105
Fax Number	:	520-624-4422

Provider Business Practice Location Address
First Line	:	1325 W SAINT MARYS RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-3112
Country	:	US
Telephone Number	:	520-624-8105
Fax Number	:	520-624-4422

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	07/08/2007

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