MEDICARE: DR. WILLIAM STULTS 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	4882	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4882	OTHER	CO	CHIROPRACTIC LICENSE

General Provider Information

NPI Number	:	1194751321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM STULTS D.C.

Provider Business Mailing Address
First Line	:	34499 WELD COUNTY ROAD 19
Second Line	:
City	:	WINDSOR
State	:	CO
Zip	:	80550
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	260 E HORSETOOTH RD
Second Line	:	SUITE 104
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3124
Country	:	US
Telephone Number	:	970-223-2866
Fax Number	:

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. WILLIAM STULTS D.C.” Practice Location

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